Successful treatment of MDS-IB2 and chronic lymphocytic leukemia with venetoclax - case report

Abstract

In this case report, we present the case of a 61-year-old female patient with chronic lymphocytic leukemia (CLL) and myelodysplastic syndrome with increased blasts 2 (MDS-IB2). The rare coincidence of these two diseases has made it possible to reaveal the therapeutic potential of venetoclax in patients with high-risk MDS. While venetoclax is a common therapeutic option in the diagnosis of CLL, it is still the subject of clinical trials in the management of MDS treatment. Due to the presumed therapeutic overlap of the mentioned BCL2 inhibitor, it was chosen in the first line for the treatment of CLL in our case report. Although the treatment was initially complicated by severe prolonged pneumonia, after a short duration of venetoclax and azacitidine both diseases were in remission and the patient was able to undergo allogeneic hematopoietic cell transplantation (HSCT). Apart from corticosensitive acute GvHD of the skin and liver, the HSCT was performed without the feared infectious complications. Even 35 months after the HSCT, the complete treatment response with 100% chimerism persists.