Double remission of simultaneously occurring secondary AML and CLL by venetoclax monotherapy

Double remission of chronic lymphocytic leukemia and secondary acute myeloid leukemia after venetoclax monotherapy

“…In 2014, a phase 2 clinical trial of venetoclax in relapsed/refractory AML with a total of 32 patients enrolled was launched, 19% relapsed and refractory AML patients got complete response/complete response with incomplete blood recovery (CR/CRi) with venetoclax. [ 17 ] Pasquale Niscola reported that a 75-year-old woman developed CLL and AML 10 years after the diagnosis of MDS-RAEB2, [ 16 ] venetoclax alone achieved transient CR, but the patient ultimately died. According to the results of an international phase Ib/II study, more than half of elderly patients with AML achieved CR rapidly after treatment with venetoclax and low-dose cytarabine.…”

“…Bcl-2 was positive in both peripheral blood and bone marrow by immunohistochemistry. So a single dose of venetoclax (400 mg once a day, according to the literature [ 16 ] ) was prescribed from June 2020, combined with measures to prevent tumor lysis syndrome. A normalization of the peripheral blood count was observed, along with clearance of the lymphocytosis.…”

“…[ 1 , 2 ] Bcl-2 inhibitors (venetoclax) were first reported to inhibit the proliferation of malignant lymphocytes and have a significant effect on patients with chronic lymphoblastic leukemia, [ 3 – 6 ] Bcl-2 inhibitors have also been reported in multiple myeloma, [ 7 , 8 ] but research on myeloid tumors is relatively delayed. [ 9 – 13 ] Venetoclax selectively binds to Bcl-2, [ 14 ] and the main effect of venetoclax is to prevent Bcl-2 from protecting cancer cells so that the cancer cells can undergo apoptosis similar to normal cells. Venetoclax was approved for the treatment of chronic lymphocytic leukemia (CLL)/small lymphocyte lymphoma, venetoclax combined with azacytidine, decitabine or low-dose cytarabine was approved in the treatment of adult acute myeloid leukemia (AML) in 2016 by the US FDA.…”

“…The outcome of this kind of patients is rather depressing, because the treatment for such patients is very limited, and only a few patients are suitable for intensive chemotherapy or allogeneic hematopoietic stem cell transplantation (allo-HSCT). [ 16 ] With the development of new diagnostic methods and innovative therapies, the treatment mode of patients is gradually improved. Here, we report a 64-year-old patient diagnosed with AML after CLL.…”

Efficacy of venetoclax and rituximab in the treatment of concurrent acute myeloid leukemia and untreated chronic lymphocytic leukemia: A case report and literature review

“…Results of numerous studies reported that members of the Bcl-2 family were abnormally expressed in various tumors, such as leukemia, lymphoma and breast cancer, and were associated with Efficacy of venetoclax and rituximab in the treatment of concurrent acute myeloid leukemia and untreated chronic lymphocytic leukemia: A case report and literature review pathogenesis and chemotherapeutic resistance (7,8). Venetoclax, which selectively binds to Bcl-2 to inhibit expression, thus inducing healthy apoptotic responses and protecting against cancer cell development, was the first Bcl-2 inhibitor to be discovered (5). Venetoclax was approved by the United States Food and Drug Administration for the treatment of CLL in 2016, and was approved for the treatment of AML that is ineligible for intensive chemotherapy in 2018.…”