Herrera-Rojas M, Cid L, Quezada A, Ortiz A, Rosales-Salinas AM, Neira JC

Language: Spanish
References: 0
Page: 187-192
PDF size: 181.10 Kb.

ABSTRACT

The pediatric treatment protocols for acute lymphoblastic leukemia (ALL) have shown benefit in adolescents and young adults; however, the behavior of the disease is not the same as in children since 40% presented with an adverse prognosis. The treatment’s objective of relapsed ALL is to obtain remission to perform an allogeneic transplant of hematopoietic stem cells (Allo-HSTC); however, it is obtained in 18 to 44% of the cases with conventional chemotherapy. In this clinical case we present the evolution of a patient with high-risk relapsed ALL who received induction treatment to remission with blinatumomab and venetoclax and subsequently an allo-HSCT. The case is about a 32-year-old male patient with acute lymphoblastic leukemia B negative Philadelphia chromosome diagnosed in May 2016 with premature suspension of maintenance therapy and subsequent relapse. The patient received induction to remission with a pediatric scheme, remaining with 33% blasts. Blinatumomab was started as monotherapy, remaining with 45% blasts, subsequently venetoclax was started, achieving the disappearance of bone marrow blasts, therefore an allo-HSCT was performed. Currently the patient is on the day +90 post transplant, with a negative minimal residual disease measured by next generation cytometry, 100% chimerism and normal peripheral blood cell count. The modification of the initial therapeutic scheme enabled this patient to receive the allo-HSCT in better conditions, increasing the possibility of success.