Successful stem cell transplantation after nelarabine, pegylated asparaginase, vincristine, doxorubicin, and prednisone in refractory early T-cell precursor acute lymphoblastic leukemia: A case report
Medwave
;
23(4): e2664, 31-05-2023.
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1436192
ABSTRACT
Early T-cell precursor Acute Lymphoblastic Leukemia (ALL) has a dismal prognosis. Nelarabine is a purine nucleoside analog that increases the apoptosis rate in T-cell lymphoblasts. We present a 30-year-old patient diagnosed with T-cell ALL. He was a high-risk patient because of an early precursor phenotype and a complex karyotype that had been refractory to three previous lines of treatment. He started a course of nelarabine (1500 mg/m for three days), pegylated-asparaginase, doxorubicin, vincristine, and prednisone (Nelarabine Peg-Asp AdmVP). He reached complete remission and received an allogeneic sibling hematopoietic stem cell transplant with fludarabine, total body irradiation, and cyclophosphamide as the conditioning regimen. He developed a pulmonary mycosis, which resolved, and grade-2 neurotoxicity in his upper and lower limbs. He was discharged after 40 days and to date remains with 23 months of complete remission. The Nelarabine Peg-Asp AdmVP regimen seems to be effective and safe. Further research is needed to establish it as an induction treatment in refractory early T-cell precursor acute lymphoblastic leucemia.
Full text:
Available
Index:
LILACS (Americas)
Language:
English
Journal:
Medwave
Journal subject:
Medicine
Year:
2023
Type:
Article
Affiliation country:
Chile
/
Japan
Institution/Affiliation country:
Facultad de Economia y Negocios, Universidad Andres Bello, Santiago, Chile/CL
/
Hematology Division, Clínica Dávila, Santiago, Chile/CL
/
Hematology Division, Clínica Las Condes, Santiago, Chile/CL
/
Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan/JP
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