Abstract：
Venetoclax, in combination with hypomethylation agents (HMAs), is a novel treatment for leukemia patients with low chemotherapy tolerance. However, it has been reported to be a risk of causing tumor lysis syndrome (TLS) in chronic lymphocytic leukemia (CLL) and elderly acute myeloid leukemia (AML) patients. Here we report a rare case of a young adult AML patient who induced TLS after receiving a combination therapy of venetoclax with decitabine (DEC). A 36-year-old male patient presented with an unexplained fever and was diagnosed with AML-M5a. The patient was first treated with a combination of antibiotics, including voriconazole 300 mg Q12h. After the infection was relieved, he was treated with 100 mg venetoclax in combination with 75 mg/m 2 DEC. However, 12 h after the first treatment, he developed diarrhea, fatigue and other symptoms, and the laboratory results were consistent with the laboratory TLS. The patient stopped chemotherapy immediately, and TLS gradually improved after receiving rehydration, diuresis, dialysis and other treatments. Finally, the patient achieved complete remission. Based on the experience of this case and related studies, we recommend the prevention of TLS should not be limited to elderly patients taking venetoclax, and it is equally important in young patients. And reduce the dosage of venetoclax when using azole antifungal drugs.
摘要：
维奈托克,与低甲基化剂（HMA）组合，是一种新的治疗白血病患者化疗耐受性低。然而,据报道,在慢性淋巴细胞性白血病(CLL)和老年急性髓细胞性白血病(AML)患者中,存在引起肿瘤溶解综合征(TLS)的风险.在这里，我们报告了一例罕见的年轻成年AML患者，该患者在接受维奈托克与地西他滨（DEC）的联合治疗后诱导了TLS。一名36岁的男性患者出现无法解释的发烧，并被诊断患有AML-M5a。患者首先接受了抗生素的联合治疗，包括伏立康唑300毫克Q12h。感染缓解后,他接受100mgvenetoclax联合75mg/m2DEC治疗。然而,第一次治疗后12小时，他出现了腹泻,疲劳和其他症状，实验室结果与实验室TLS一致。病人立即停止化疗,接受补液后TLS逐渐改善，利尿,透析和其他治疗。最后,患者达到完全缓解。根据本案的经验和相关研究，我们建议预防TLS不应仅限于服用维奈托克的老年患者，这对年轻患者同样重要。并在使用唑类抗真菌药物时减少维奈托克的剂量。
