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Shi H, Yang F, Cao M, Xu T, Zheng P, Guo Y, Su G, Feng S, Li R, Liu R, Liu H, Ma L, Ke X, Hu K. Daratumumab and venetoclax combined with CAGE for late R/R T-ALL/LBL patients: Single-arm, open-label, phase I study. Ann Hematol 2024; 103:2993-3004. [PMID: 38662205 DOI: 10.1007/s00277-024-05775-z] [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: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 04/26/2024]
Abstract
The prognosis of patients diagnosed with relapsed or refractory (R/R) T-lymphoblastic leukemia/lymphoma (T-ALL/LBL) has consistently been unsatisfactory, with limited treatment options. As reports, the CAG regimen can serve as a salvage treatment for R/R T-ALL/LBL, but there remains a subset of patients who do not benefit from it. Recent studies have indicated that daratumumab (Dara) and venetoclax (Ven) may offer promising therapeutic benefits for T-ALL/LBL. In light of these findings, we conducted a safety and efficacy evaluation of the enhanced treatment regimen, combining Dara and Ven with aclarubicin, cytarabine, granulocyte colony-stimulating factor, and etoposide (CAGE), in patients suffering from R/R T-ALL/LBL. The participants in this phase I trial were patients with R/R T-ALL/LBL who fail to standard treatment regimens. During each 28-day cycle, the patients were treated by Dara, Ven, cytarabine, aclarubicin, granulocyte colony-stimulating factor, etoposide. The primary endpoint of this study was the rate of remission. This report presents the prospective outcomes of 21 patients who received the salvage therapy of Dara and Ven combined with the CAGE regimen (Dara + Ven + CAGE). The objective remission rate (ORR) was determined to be 57.1%, while the complete remission (CR) rate was 47.6%. Notably, patients with the early T-cell precursor (ETP) subtype exhibited a significantly higher remission rate in the bone marrow compared to non-ETP patients (100% vs. 44.4%, p = 0.044). The Dara + Ven + CAGE regimen demonstrated a favorable remission rate in patients with R/R T-ALL/LBL. Moreover, the treatment was well-tolerated.
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Affiliation(s)
- Hui Shi
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Fan Yang
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Miaomiao Cao
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Teng Xu
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Peihao Zheng
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Yuelu Guo
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Guoai Su
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Shaomei Feng
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Ruiting Li
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Rui Liu
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Haidi Liu
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Lixia Ma
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China
| | - Xiaoyan Ke
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China.
- Department of Hematology, Peking University Third Hospital, Beijing, 100191, China.
| | - Kai Hu
- Department of Lymphoma and Myeloma Research Center, Beijing Gobroad Boren Hospital, Beijing, 100070, China.
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Rinella SP, Bell HC, Hess NJ, Hoang NM, Nguyen TT, Turicek DP, Shi L, Rui L, LaBelle JL, Capitini CM. Combination fedratinib and venetoclax has activity against human B-ALL with high FLT3 expression. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.06.07.544058. [PMID: 37333339 PMCID: PMC10274796 DOI: 10.1101/2023.06.07.544058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Treatment of relapsed/refractory B cell acute lymphoblastic leukemia (B-ALL) remains a challenge, particularly in patients who do not respond to traditional chemotherapy or immunotherapy. The objective of this study was to assess the efficacy of fedratinib, a semi selective JAK2 inhibitor and venetoclax, a selective BCL-2 inhibitor, on human B-ALL using both single-agent and combinatorial treatments. The combination treatment of fedratinib and venetoclax improved killing of the human B-ALL cell lines RS4;11 and SUPB-15 in vitro over single-agent treatments. This combinatorial effect was not detected in the human B-ALL cell line NALM-6, which was less responsive to fedratinib due to the absence of Flt3 expression. The combination treatment induces a unique gene expression profile relative to single-agent treatment and with an enrichment in apoptotic pathways. Finally, the combination treatment was superior to single agent treatment in an in vivo xenograft model of human B-ALL, with a two-week treatment regimen significantly improving overall survival while inducing CD19 expression. Overall, our data demonstrates the efficacy of a combinatorial treatment strategy of fedratinib and venetoclax against human B-ALL expressing high levels of Flt3.
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Affiliation(s)
- Sean P Rinella
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Haley C Bell
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nicholas J Hess
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nguyet-Minh Hoang
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Thao Trang Nguyen
- Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - David P Turicek
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Lei Shi
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - James L LaBelle
- Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Christian M Capitini
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL
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3
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Bisegna ML, Peragine N, Elia L, Matarazzo M, Milani ML, Intoppa S, Di Trani M, Malfona F, Martelli M, De Propris MS. NG2 Molecule Expression in Acute Lymphoblastic Leukemia B Cells: A Flow-Cytometric Marker for the Rapid Identification of KMT2A Gene Rearrangements. Mediterr J Hematol Infect Dis 2024; 16:e2024018. [PMID: 38468826 PMCID: PMC10927233 DOI: 10.4084/mjhid.2024.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
Background B-lineage acute lymphoblastic leukemias (B-ALL) harboring rearrangements of the histone lysine [K]-Methyltransferase 2A (KMT2A) gene on chromosome 11q23 (KMT2A-r) represent a category with dismal prognosis. The prompt identification of these cases represents an urgent clinical need. Considering the correlation between rat neuron glial-antigen 2 (NG2) chondroitin-sulfate-proteoglycan molecule expression and KMT2A-r, we aimed to identify an optimized cytofluorimetric diagnostic panel to predict the presence of KMT2A-r. Materials and Methods We evaluated 88 NG2+ B-ALL cases identified with an NG2 positivity threshold >10% from a cohort of 1382 newly diagnosed B-ALLs referred to the Division of Hematology of 'Sapienza' University of Rome. Results Eighty-five of 88 (96.6%) NG2+ B-ALLs harbored KMT2A-r and were mainly pro-B ALL (77/85; 91%). Only 2 B-ALLs with KMT2A-r showed NG2 expression below 10%, probably due to the steroid therapy administered prior to cytofluorimetric analysis.Compared to KMT2A-r-cases, KMT2A r+ B-ALLs showed a higher blast percentage, significantly higher mean fluorescence intensity (MFI) of CD45, CD38, and CD58, and significantly lower MFI of CD34, CD22, TdT, and CD123.The study confirmed differences in CD45, CD34, CD22, and TdT MFI within the same immunologic EGIL group (European Group for the immunological classification of leukemias), indicating no influence of the B-ALLs EGIL subtype on the KMT2A-r+ B-ALLs immunophenotype. Conclusions Our data demonstrate the association between NG2 and KMT2A-r in B-ALLs identify a distinctive immunophenotypic pattern, useful for rapid identification in diagnostic routines of these subtypes of B-ALLs with a poor prognosis that benefits from a specific therapeutic approach.
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Affiliation(s)
| | | | - Loredana Elia
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Mabel Matarazzo
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maria Laura Milani
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Stefania Intoppa
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Mariangela Di Trani
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Francesco Malfona
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maurizio Martelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
| | - Maria Stefania De Propris
- Hematology, Department of Translational and Precision Medicine, Sapienza University, 00161 Rome, Italy
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Bai W, Liu D, Cheng Q, Yang X, Zhu L, Qin L, Fang J. Tetraarsenic tetrasulfide triggers ROS-induced apoptosis and ferroptosis in B-cell acute lymphoblastic leukaemia by targeting HK2. Transl Oncol 2024; 40:101850. [PMID: 38043497 PMCID: PMC10701457 DOI: 10.1016/j.tranon.2023.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/14/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023] Open
Abstract
PURPOSE Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children. Despite cure rates of higher than 85 %, refractory or relapsed ALL still exhibits a bleak prognosis indicative of the dearth of treatment modalities specific for relapsed or refractory ALL. Prior research has implicated metabolic alterations in leukemia pathogenesis, and literature on the therapeutic efficacy of arsenic compounds targeting metabolic pathways in B-cell acute lymphoblastic leukemia (B-ALL) cells is scarce. METHODS A compound extracted from realgar, tetraarsenic tetrasulfide (As4S4), and its antitumor effects on B-ALL were experimentally examined in vitro and in vivo. RESULTS As4S4 apparently targets B-ALL cells by inducing specific cellular responses, including apoptosis, G2/M arrest, and ferroptosis. Interestingly, these effects are attributed to reactive oxygen species (ROS) accumulation, and increased ROS levels have been linked to both the mitochondria-dependent caspase cascade and the activation of p53 signaling. The ROS scavenger N-acetylcysteine (NAC) can counteract the effects of As4S4 treatment on Nalm-6 and RS4;11 cells. Specifically, by targeting Hexokinase-2 (HK2), As4S4 induces alterations in mitochondrial membrane potential and disrupts glucose metabolism, leading to ROS accumulation, and was shown to inhibit B-ALL cell proliferation in vitro and in vivo. Intriguingly, overexpression of HK2 can partially desensitize B-ALL cells to As4S4 treatment. CONCLUSION Tetraarsenic tetrasulfide can regulate the Warburg effect by controlling HK2 expression, a finding that provides both new mechanistic insight into metabolic alterations and pharmacological evidence for the clinical treatment of B-ALL.
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Affiliation(s)
- Wenke Bai
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China
| | - Diandian Liu
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China
| | - Qianyi Cheng
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China
| | - Xingge Yang
- Department of Pediatrics, the First Affiliated Hospital of Henan University of Science and Technology, 24 Jinghua Road Luoyang, Henan 471003, China
| | - Liwen Zhu
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China
| | - Lijun Qin
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China.
| | - Jianpei Fang
- Department of Pediatrics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, 107 Yanjiang West Road, Guangzhou, Guangdong 510120, China.
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5
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Borah P, Dayal N, Pathak S, Naithani R. Daratumumab-a novel treatment strategy in relapsed/refractory acute leukemia. Ann Hematol 2023; 102:3291-3293. [PMID: 37558803 DOI: 10.1007/s00277-023-05404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Pronamee Borah
- Department of Hematology and Bone Marrow Transplant, Paras Health, Gurugram, 122002, India
| | - Nitin Dayal
- Department of Lab Medicine, Max Superspecialty Hospital, Delhi, India
| | - Sangeeta Pathak
- Department of Transfusion Medicine, Max Superspecialty Hospital, Delhi, India
| | - Rahul Naithani
- Department of Hematology and Bone Marrow Transplant, Paras Health, Gurugram, 122002, India.
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6
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Edahiro T, Ureshino H, Chishaki R, Fujino K, Mino T, Yoshida T, Fukushima N, Ichinohe T. Successful combination treatment with azacitidine and venetoclax as a bridging therapy for third allogenic stem cell transplantation in a patient with 11q23/MLL-rearranged complex karyotype acute myeloid leukemia. EJHAEM 2023; 4:273-275. [PMID: 36819153 PMCID: PMC9928651 DOI: 10.1002/jha2.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/28/2022]
Abstract
Translocation t(6;11) occurs in approximately 5% of patients with acute myeloid leukemia (AML) corresponding to 11q23/mixed lineage leukemia (MLL) rearrangement. The AF6 gene on chromosome 6q27 is the fusion partner of the MLL gene on 11q23 in t(6;11), which results in a poor prognosis. The case of a patient with 11q23/MLL-rearranged AML who successfully underwent a third allogeneic stem cell transplantation after treatment with azacitidine (AZA) and venetoclax (VEN) is presented in this article. This report suggests that a combination of AZA and VEN is an effective therapeutic approach for relapsed and refractory MLL-rearranged AML.
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Affiliation(s)
- Taro Edahiro
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | - Hiroshi Ureshino
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
- Next Generation Development of Genome and Cellular Therapy ProgramResearch Institute for Radiation Biology and Medicine (RIRBM)Hiroshima UniversityHiroshimaJapan
| | - Ren Chishaki
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | - Keita Fujino
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | - Tatsuji Mino
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | - Tetsumi Yoshida
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | | | - Tatsuo Ichinohe
- Department of Hematology and OncologyResearch Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
- Next Generation Development of Genome and Cellular Therapy ProgramResearch Institute for Radiation Biology and Medicine (RIRBM)Hiroshima UniversityHiroshimaJapan
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7
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Stanulla M, Schewe DM, Bornhauser B, Bourquin JP, Eckert C, Eberl W, Wolf S, Wolf J, Vogiatzi F, Bergmann AK, Cario G, Beier R, Sauer M, Kratz CP, Maecker-Kolhoff B. Molecular complete remission following combination treatment of daratumumab and venetoclax in an adolescent with relapsed mixed phenotype acute leukemia. Ann Hematol 2023; 102:669-672. [PMID: 36651980 PMCID: PMC9977701 DOI: 10.1007/s00277-023-05083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Martin Stanulla
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
| | - Denis M. Schewe
- grid.5807.a0000 0001 1018 4307Department of Pediatrics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Beat Bornhauser
- grid.412341.10000 0001 0726 4330Division of Pediatric Oncology, and Children Research Center, University Children’s Hospital, Zurich, Switzerland
| | - Jean-Pierre Bourquin
- grid.412341.10000 0001 0726 4330Division of Pediatric Oncology, and Children Research Center, University Children’s Hospital, Zurich, Switzerland
| | - Cornelia Eckert
- grid.6363.00000 0001 2218 4662Charité, University Hospital Berlin, Pediatric Hematology/Oncology, Berlin, Germany
| | - Wolfgang Eberl
- grid.419806.20000 0004 0558 1406Center for Child and Adolescent Medicine, Department of Hematology and Oncology, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany
| | - Saskia Wolf
- grid.5807.a0000 0001 1018 4307Department of Pediatrics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Julian Wolf
- grid.5807.a0000 0001 1018 4307Department of Pediatrics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Fotini Vogiatzi
- grid.412468.d0000 0004 0646 2097Pediatric Hematology/Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Anke K. Bergmann
- grid.10423.340000 0000 9529 9877Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Gunnar Cario
- grid.412468.d0000 0004 0646 2097Pediatric Hematology/Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Rita Beier
- grid.10423.340000 0000 9529 9877Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Martin Sauer
- grid.10423.340000 0000 9529 9877Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Christian P. Kratz
- grid.10423.340000 0000 9529 9877Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
| | - Britta Maecker-Kolhoff
- grid.10423.340000 0000 9529 9877Department of Pediatric Hematology and Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany
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8
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Li X, Zhu H, Sui T, Zhao X, Deng Q. A Case of Daratumumab-Induced Significant Decrease in Donor-Specific HLA Antibodies and Remission Induction Before Haploidentical Stem Cell Transplantation in a Refractory B-ALL Patient. Cell Transplant 2022; 31:9636897221132502. [PMID: 36278404 PMCID: PMC9597015 DOI: 10.1177/09636897221132502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To explore the method of eliminating donor-specific anti-HLA antibodies (DSA)
in haploidentical stem cell transplantation (haplo-SCT). Methods: We present a refractory B-cell acute lymphoblastic leukemia (ALL) patient who
had strongly positive DSA, but had no human leukocyte antigen–matched donor.
Although CD38 expression on leukemia cells was negative, daratumumab
combined with etoposide and venetoclax therapy was chosen for her. Results: She achieved a significant decrease in DSA levels and complete remission on
the combination therapy with daratumumab. She then received a haplo-SCT from
a daughter as a donor and had a successful engraftment of donor stem cell.
In haplo-SCT, strongly positive DSA levels, directed against donor HLA
antigens, could be significantly reduced by daratumumab therapy before
transplantation and successfully bridge subsequent haplo-SCT. Conclusion: Although CD38 expression is negative in leukemia cells, refractory B-ALL
patients may still benefit from combination therapy with daratumumab. We
need further clinical observation.
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Affiliation(s)
- Xin Li
- Department of Hematology, Tianjin First
Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Haibo Zhu
- Department of Hematology, Tianjin First
Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Tao Sui
- Department of Hematology, Tianjin First
Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Xingli Zhao
- Departments of Oncology and Hematology,
Tianjin People’s Hospital, School of Medicine, Nankai University, Tianjin,
China
| | - Qi Deng
- Department of Hematology, Tianjin First
Central Hospital, School of Medicine, Nankai University, Tianjin, China,Qi Deng, Department of Hematology, Tianjin
First Central Hospital, School of Medicine, Nankai University, No. 24, Fukang
Road, Tianjin 300192, China.
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9
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The Emerging Role of Venetoclax-Based Treatments in Acute Lymphoblastic Leukemia. Int J Mol Sci 2022; 23:ijms231810957. [PMID: 36142863 PMCID: PMC9504828 DOI: 10.3390/ijms231810957] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Venetoclax, a B-cell lymphoma (BCL-2) inhibitor, in combination with hypomethylating agents has become the new standard of care in elderly and unfit patients with acute myeloid leukemia, with significantly improved overall survival and quality of life. Studies of venetoclax combined with high-dose chemotherapy are emerging with evidence of higher rates of molecular remission. Recently, a growing number of publications bring forth the use of venetoclax in patients with acute lymphoblastic leukemia (ALL). In the current review, we present the biological rationale of BCL-2 inhibition in ALL, how the interplay of BH3 proteins modulate the response and the current clinical experience with various combinations.
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