1
|
Shiomi I, Nakako S, Nakane T, Ogawa Y, Araki T, Fujitani Y, Yamamura R, Hino M, Nakamae H. Effectiveness of venetoclax and azacytidine against myeloid/natural killer cell precursor acute leukemia. Int J Hematol 2024; 119:88-92. [PMID: 38010569 DOI: 10.1007/s12185-023-03678-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023]
Abstract
Myeloid/natural killer (NK) cell precursor acute leukemia (MNKPL) is a rare leukemia subtype that possibly originates from precursor NK cells. The disease has a poor prognosis, and information on its treatment is lacking. We herein report the first case of a 46-year-old woman with MNKPL who was refractory to two lines of acute myeloid leukemia (AML)-type intensive chemotherapy but was successfully treated with venetoclax and azacytidine (VEN/AZA). She was diagnosed with MNKPL based on the conformations of immature lymphoblastoid morphology without myeloperoxidase reactivity that showed a CD7/CD33/CD34/CD56/HLA-DR positive phenotype and extramedullary regions. The disease was refractory to induction therapy with daunorubicin and cytarabine (DNR/Ara-C) and to reinduction therapy with mitoxantrone, etoposide, and cytarabine (MEC). After two lines of induction chemotherapy, massive pericardial and pleural effusion was found, and was suspected to be extramedullary lesions. The patient developed cardiac tamponade and required pericardiocentesis. Thus, VEN/AZA was administered as third-line therapy. After two cycles of VEN/AZA, the pericardial and pleural effusion disappeared, and complete remission was achieved. The patient received post-transplant cyclophosphamide-based haploidentical transplantation and has stayed relapse-free as of her last follow-up examination 2 years after diagnosis.
Collapse
Affiliation(s)
- Ichiro Shiomi
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan
| | - Soichiro Nakako
- Department of Hematology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Takahiko Nakane
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan.
| | - Yumi Ogawa
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan
| | - Taku Araki
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan
| | - Yotaro Fujitani
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan
| | - Ryosuke Yamamura
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, Kita-Ku, Osaka, 530-0012, Japan
| | - Masayuki Hino
- Department of Hematology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| |
Collapse
|
2
|
Aref S, Rizk R, El Agdar M, Fakhry W, El Zafrany M, Sabry M. NOTCH-1 Gene Mutations Influence Survival in Acute Myeloid Leukemia Patients. Asian Pac J Cancer Prev 2020; 21:1987-1992. [PMID: 32711424 PMCID: PMC7573420 DOI: 10.31557/apjcp.2020.21.7.1987] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although NOTCH-1 gene mutations were reported to contributes to leukemogenesis in lymphocytic leukemias, its role in acute myeloid leukemia (AML) remains unclear. Therefor; this study was designed to determine the prevalence and clinical impact of NOTCH-1 mutations in AML patients. MATERIALS AND METHODS In the current study, NOTCH-1 gene mutations were identified in Bone Marrow samples obtained from fifty primary AML patients before start of therapy using Sanger sequencing. RESULTS NOTCH-1 gene mutations were detected in 6 out of 50 AML cases (12%). The three mutations were (two mutations C7318A in the Pest domain exon 34); (another 2 in the Pest domain Del 7,344, ins C7349, G7356A and the last ones in the HD-N exon-26 (Del A4609). The clinical findings in the mutant AML (mu AML) patients did not significantly different as compared to the un mutated (unmut) AML patients. There is significant association between CD7 aberrant expression and NOTCH-1 mutations. The complete remission was significantly higher in unmut AML cases as compared to mut AML ones (P=0.024). Multivariate (Age; Gender; Bone Marrow Blast cells; NOTCH-1 mutations) Cox regression analysis revealed that NOTCH-1 mutation is an independent risk factor for AML overall survival (P<0.001). The OS in unmut AML group (21.2 months) was significantly longer as compared to mut AML one (1.2 months) (P<0.001). CONCLUSION Our data indicate that NOTCH-1 gene mutations were detected in 12% of AML patients. These mutations displayed bad clinical outcome on AML patients. Therapeutic targeting of NOTCH-1 could be a potentially effective approach to combat master oncogenic drivers in AML.
Collapse
Affiliation(s)
- Salah Aref
- Hematology Unit, Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
| | - Rasha Rizk
- Hematology Unit, Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
| | - Mohamed El Agdar
- Hematology Unit, Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
| | - Wafaa Fakhry
- Hematology Unit, Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
| | - Maha El Zafrany
- Medical Oncology Unit, Mansoura University Oncology Center, Mansoura University, Egypt.
| | - Mohamed Sabry
- Hematology Unit, Clinical Pathology Department, Mansoura University Faculty of Medicine, Mansoura, Egypt.
| |
Collapse
|
3
|
Noguchi Y, Tomizawa D, Hiroki H, Miyamoto S, Tezuka M, Miyawaki R, Tanaka‐Kubota M, Okano T, Kobayashi C, Mitsuiki N, Aoki Y, Imai K, Kajiwara M, Kanegane H, Morio T, Takagi M. Hematopoietic cell transplantation for myeloid/NK cell precursor acute leukemia in second remission. Clin Case Rep 2018; 6:1023-1028. [PMID: 29881556 PMCID: PMC5986054 DOI: 10.1002/ccr3.1506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 11/07/2022] Open
Abstract
Myeloid/natural killer cell precursor acute leukemia (MNKPL) is a rare leukemia subtype characterized by a high incidence of extramedullary infiltration. No appropriate treatment strategy has so far been developed. Acute myelogenous leukemia-type chemotherapy combined with L-Asparaginase is an effective treatment for MNKPL. Hematopoietic cell transplantation is a second option in refractory cases.
Collapse
Affiliation(s)
- Yusuke Noguchi
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Daisuke Tomizawa
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
- Division of Leukemia and LymphomaChildren's Cancer CenterNational Center for Child Health and DevelopmentOkura 2‐10‐1, Setagaya‐kuTokyoJapan
| | - Haruka Hiroki
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Satoshi Miyamoto
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Mari Tezuka
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
- Department of PediatricsEhime Prefectural Central HospitalKasuga 83MatsuyamaEhimeJapan
| | - Reiji Miyawaki
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
- Department of PediatricsMatsuyama Red Cross HospitalBunkyo‐choMatsuyamaEhimeJapan
| | - Mari Tanaka‐Kubota
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Tubasa Okano
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Chika Kobayashi
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Noriko Mitsuiki
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Yuki Aoki
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
- Department of Pediatrics OncologyNational Cancer Research CenterTsukiji 5‐1‐1, Chuo‐kuTokyoJapan
| | - Kohsuke Imai
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Michiko Kajiwara
- Department of Transfusion MedicineGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Hirokazu Kanegane
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental BiologyGraduate School of MedicineTokyo Medical and Dental UniversityYushima 1‐5‐45, Bunkyo‐kuTokyoJapan
| |
Collapse
|