IDH2-mutated near ETP-ALL with aggressive leukemia cutis and brisk response to venetoclax and decitabine

Poorva Vaidya; Huan-You Wang; Michelle D Don; Brian R Hinds; James K Mangan

doi:10.1016/j.lrr.2023.100408

IDH2-mutated near ETP-ALL with aggressive leukemia cutis and brisk response to venetoclax and decitabine

Leuk Res Rep. 2023 Dec 30:21:100408. doi: 10.1016/j.lrr.2023.100408. eCollection 2024.

Authors

Poorva Vaidya¹, Huan-You Wang², Michelle D Don², Brian R Hinds³, James K Mangan⁴

Affiliations

¹ Department of Internal Medicine, Division of Hematology-Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.
² Department of Pathology, University of California, San Diego, La Jolla, CA, United States.
³ Department of Dermatology, University of California, San Diego, La Jolla, CA, United States.
⁴ Department of Internal Medicine, Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.

Abstract

Near early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) is a rare hematologic malignancy, for which second line therapeutic options are limited. T-cell leukemias are also rarely associated with leukemia cutis, which is more often seen in leukemias of myeloid origin. We present the case of an adult male diagnosed with near ETP-ALL, with IDH2 and DNMT3A mutations, suggestive of a myeloid origin, and leukemia cutis. After the patient progressed on hyper-CVAD and nelarabine, we treated him with the BCL-2 inhibitor venetoclax and the hypomethylating agent decitabine. The regimen induced a rapid bone marrow response and resolution of the leukemia cutis.

Keywords: Hypomethylating agents; Leukemia cutis; T-cell lymphoblastic leukemia; Venetoclax.

Publication types

Case Reports