Successful treatment with blinatumomab for acute lymphoblastic leukemia in an older adult patient complicated with hepatocarcinoma.

blinatumomab 成功治疗老年肝癌并发急性淋巴细胞白血病。

• 发表时间: 2024
• 来源期刊: Leuk Res Rep
• DOI: 10.1016/j.lrr.2024.100413
• PMID: 38348414
• 文章类型: Case Reports
• 作者列表: Saburi M,Sakata M,Maruyama R,Kodama Y,Uraisami K,Takata H,Miyazaki Y,Kawano K,Kodama Y,Ohtsuka E

关键词: Acute lymphoblastic leukemia; Blinatumomab; Hepatic cirrhosis; Hepatocarcinoma; Older adult

Abstract

An 82-year-old man with Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL) complicated by hepatocarcinoma was presented. Remission induction therapy of hyper-CVAD with half dose reduction achieved hematological complete remission (CR), but accompanied with elevated alanine aminotransferase and hyperbilirubinemia. The patient was thought intolerable for hyper-CVAD with half dose reduction due to liver toxicity, and treatment was switched to blinatumomab. Hematological CR was sustained after nine cycles of blinatumomab without exacerbation of liver dysfunction. After five courses of blinatumomab, hepatocarcinoma was treated successfully by trans-arterial chemoembolization. Two years after the diagnosis of ALL, the patient was alive in CR status of ALL.

摘要

介绍了一名82岁的费城染色体阴性急性淋巴细胞白血病（ALL）并发肝癌的男性。hyper-CVAD半剂量减少的缓解诱导治疗达到血液学完全缓解（CR），但伴有丙氨酸转氨酶升高和高胆红素血症。由于肝毒性，该患者被认为对高CVAD患者无法忍受，剂量减少了一半。治疗改用Blinatumomab。blinatumomab治疗9个周期后，血液学CR得以维持，未加重肝功能障碍。经过五个疗程的Blinatumomab,经动脉化疗栓塞成功治疗肝癌。诊断出ALL两年后，患者在ALL的CR状态下存活。