Successful nelarabine and venetoclax treatment of a relapsed/refractory mediastinal myeloid sarcoma with clonal TCR rearrangement.
Antineoplastic Agents
/ therapeutic use
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Arabinonucleosides
/ therapeutic use
Bridged Bicyclo Compounds, Heterocyclic
/ therapeutic use
Hematopoietic Stem Cell Transplantation
Humans
Male
Mediastinal Neoplasms
/ drug therapy
Middle Aged
Sarcoma, Myeloid
/ drug therapy
Sulfonamides
/ therapeutic use
Journal
Anti-cancer drugs
ISSN: 1473-5741
Titre abrégé: Anticancer Drugs
Pays: England
ID NLM: 9100823
Informations de publication
Date de publication:
01 11 2021
01 11 2021
Historique:
pubmed:
20
6
2021
medline:
4
2
2022
entrez:
19
6
2021
Statut:
ppublish
Résumé
Myeloid sarcomas represent a heterogeneous group of diseases with a tumoral presentation of acute myeloid leukemia. The clinical presentation of these hematologic cancers is typically aggressive and thus rapidly fatal in the absence of treatment, which relies on intensive chemotherapy that is sometimes followed by allogeneic hematopoietic stem-cell transplant (AHSCT). However, the global treatment strategy for these lesions is currently not well established. We report the case of a patient presenting with a highly refractory mediastinal myeloid sarcoma with uncommon morphologic and phenotypic characteristics and a clonal TCR rearrangement. The patient's disease was progressive despite multiple courses of intensive chemotherapy and a combination of nelarabine and venetoclax finally led to a complete metabolic response consolidated by an AHSCT. This treatment regimen, which has never been reported before, was very well tolerated especially on the neurologic and hematologic levels. This case underlines the clinical, histologic and molecular heterogeneity of what is called myeloid sarcoma and the importance of next-generation sequencing analysis of the tumor mass with both myeloid and lymphoid panels to better classify this rare entity and identify therapeutic targets.
Identifiants
pubmed: 34145177
doi: 10.1097/CAD.0000000000001105
pii: 00001813-202112000-00018
doi:
Substances chimiques
Antineoplastic Agents
0
Arabinonucleosides
0
Bridged Bicyclo Compounds, Heterocyclic
0
Sulfonamides
0
nelarabine
60158CV180
venetoclax
N54AIC43PW
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1118-1122Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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