# Successful Treatment With Venetoclax Plus Azacytidine Combined With Radiation Therapy and Donor Lymphocyte Infusion in a Patient With Extramedullary Relapse of Acute Myeloid Leukemia After Stem Cell Transplantation

## TL;DR

A patient with rare extramedullary relapse of AML after a stem cell transplant was successfully treated with a combination of venetoclax, azacytidine, radiation therapy, and donor lymphocyte infusion.

## Contribution

This case report demonstrates the potential efficacy of combining venetoclax and azacytidine with radiation and donor lymphocyte infusion for post-transplant extramedullary AML relapse.

## Key findings

- The combination therapy led to promising results in a patient with extramedullary AML relapse after stem cell transplantation.
- Venetoclax and azacytidine showed efficacy in salvage treatment following radiation therapy and donor lymphocyte infusion.

## Abstract

Extramedullary (EM) relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia (AML) is rare and causes systemic relapse. Consequently, the prognosis is very poor because limited treatment is feasible in post-transplant patients. The efficacy and safety of venetoclax (VEN), a newly developed oral inhibitor of B-cell leukemia/lymphoma-2, plus azacytidine (AZA) in patients newly diagnosed with AML who are ineligible for intensive chemotherapy have been reported. We report a case in which VEN + AZA salvage treatment following radiation therapy and donor lymphocyte infusion afforded promising results in a patient with AML who showed post-allo-HSCT EM relapse.