Molecular complete remission following combination treatment of daratumumab and venetoclax in an adolescent with relapsed mixed phenotype acute leukemia

Abstract

Here, we report on a twelve-year-old boy diagnosed with mixed phenotype acute leukemia (T cell ALL/acute myeloid leukemia, AML) bearing a KMT2A::MLLT4 fusion in June 2018. First-line treatment was initiated according to the AIEOP-BFM ALL 2009 registry protocol and demonstrated a poor response to the prednisone prephase and high leukemic cell loads by measurable residual disease (MRD) during and after induction therapy (Fig. 1A) [1,2]. After subsequent application of an AML-type treatment (AIE regimen: cytarabine, idarubicin, and etoposide), an ALL-BFM high-risk block (dexamethasone, vincristine, methotrexate, cyclophosphamide, cytarabine, L-asparaginase,