Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report
For patients with primary refractory AML, allogeneic hematopoietic cell transplantation (allo-HCT) is considered the only curative approach. However, the therapeutic efficacy of salvage transplantation in the non-remission (NR) state remains controversial. We present a patient with primary refractor...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1329858/full |
| _version_ | 1797390058104291328 |
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| author | Yili Fan Luyao Wang Boxiao Chen Jiawei Zhang Luyu Yang Xi Qiu Huawei Jiang Lei Zhu Chao Wang Yang Xu |
| author_facet | Yili Fan Luyao Wang Boxiao Chen Jiawei Zhang Luyu Yang Xi Qiu Huawei Jiang Lei Zhu Chao Wang Yang Xu |
| author_sort | Yili Fan |
| collection | DOAJ |
| description | For patients with primary refractory AML, allogeneic hematopoietic cell transplantation (allo-HCT) is considered the only curative approach. However, the therapeutic efficacy of salvage transplantation in the non-remission (NR) state remains controversial. We present a patient with primary refractory AML and concomitant central nervous system (CNS) leukemia, who received salvage allo-HCT, localized radiotherapy and venetoclax maintenance. Although he experienced systemic chronic graft-versus-host disease (cGVHD), he remained disease-free for 2 years. We propose that salvage transplantation is a feasible for primary refractory AML and discuss strategies to prevent relapse after allo-HCT, including maintenance therapy and donor lymphocyte infusion (DLI). Finally, we highlight the importance of radiotherapy, which can exert immunomodulatory effects to enhance immune responses against leukemia. |
| first_indexed | 2024-03-08T23:05:08Z |
| format | Article |
| id | doaj.art-1e10298fe1024619981013fa668c5cb0 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-08T23:05:08Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-1e10298fe1024619981013fa668c5cb02023-12-15T13:43:38ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-12-011310.3389/fonc.2023.13298581329858Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case reportYili Fan0Luyao Wang1Boxiao Chen2Jiawei Zhang3Luyu Yang4Xi Qiu5Huawei Jiang6Lei Zhu7Chao Wang8Yang Xu9Department of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaDepartment of Laboratory Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Hematology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, ChinaFor patients with primary refractory AML, allogeneic hematopoietic cell transplantation (allo-HCT) is considered the only curative approach. However, the therapeutic efficacy of salvage transplantation in the non-remission (NR) state remains controversial. We present a patient with primary refractory AML and concomitant central nervous system (CNS) leukemia, who received salvage allo-HCT, localized radiotherapy and venetoclax maintenance. Although he experienced systemic chronic graft-versus-host disease (cGVHD), he remained disease-free for 2 years. We propose that salvage transplantation is a feasible for primary refractory AML and discuss strategies to prevent relapse after allo-HCT, including maintenance therapy and donor lymphocyte infusion (DLI). Finally, we highlight the importance of radiotherapy, which can exert immunomodulatory effects to enhance immune responses against leukemia.https://www.frontiersin.org/articles/10.3389/fonc.2023.1329858/fullprimary refractory acute myeloid leukemiaallogeneic hematopoietic cell transplantationrelapseradiotherapygraft versus leukemia |
| spellingShingle | Yili Fan Luyao Wang Boxiao Chen Jiawei Zhang Luyu Yang Xi Qiu Huawei Jiang Lei Zhu Chao Wang Yang Xu Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report Frontiers in Oncology primary refractory acute myeloid leukemia allogeneic hematopoietic cell transplantation relapse radiotherapy graft versus leukemia |
| title | Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report |
| title_full | Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report |
| title_fullStr | Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report |
| title_full_unstemmed | Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report |
| title_short | Long-term survival in a patient with primary refractory AML after salvage allogeneic hematopoietic transplantation and post-transplant localized irradiation and venetoclax maintenance: a case report |
| title_sort | long term survival in a patient with primary refractory aml after salvage allogeneic hematopoietic transplantation and post transplant localized irradiation and venetoclax maintenance a case report |
| topic | primary refractory acute myeloid leukemia allogeneic hematopoietic cell transplantation relapse radiotherapy graft versus leukemia |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1329858/full |
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