维奈克拉联合阿扎胞苷治疗原发性骨髓纤维化转急性巨核细胞白血病1例并文献复习

Venetoclax combined with azacitidine in treatment of acute megakaryoblastic leukemia transformed from primary myelofibrosis:report of 1 case and review of literature

本文回顾性分析甘肃省人民医院1例应用维奈克拉联合阿扎胞苷治疗的原发性骨髓纤维化转化的急性单核细胞白血病老年患者的临床资料,并复习相关文献。本例患者系72岁,男性,诊断原发性骨髓纤维化经芦可替尼治疗2年后转化为急性单核细胞白血病,遂给予维奈克拉联合阿扎胞苷治疗。患者第1疗程后部分缓解,临床症状改善明显。第2疗程后,患者完全缓解,流式微小残留病灶阴性,但持续粒细胞缺乏状态长达45 d,最终因感染死亡。

We retrospectively analyzed the clinical data of an elderly patient of acute megakaryoblastic leukemia transformed from primary myelofibrosis treated with venetoclax combined with azacitidine in Gansu Provincial People's Hospital and reviewed the relevant literature.This patient,a 72-year-old man,was diagnosed with primary myelofibrosis and was transformed to acute megakaryoblastic leukemia after 2 years of treatment with ruxolitinib,then given venetoclax combined with azacitidine.After the first course of treatment,the patient had partial remission of bone marrow and clinical improvement significantly.After the second course of treatment,although the bone marrow had complete remission and flow minimal residual disease(MRD) was negative,agranulocytosis persisted for up to 45 days and finally died due to infection.