Venetoclax for refractory plasma cell leukemia – pro
VEntoclax in combination or by itself is a very promising approach, but only case reports have so far been published and it is still E/I . Primary plasma cell leukemia remains one of the most aggressive hematologic cancers with poor clinical outcome. In particular elderly patients, such as the one in this report, have limited therapeutic options as their age, and often performance status makes them unfit for aggressive therapy including stem cell transplantation. In addition, renal compromise, which is evident in up to 50% of pPCL patients, precludes the use of various antiMM therapies which further narrows down possible treatment options. Up to 60% of pPCL patients present with a translocation t(11;14), for which venetoclax may be useful.The Chim paper says: ” b. In ‘advanced’ relapse, clinical trials of agents with novel mechanism including exportin-1 inhibitor (selinexor combinations), or BCL2 inhibitor (venetoclax combinations) in addition to immunotherapy (anti-B-cell maturation antigen CAR-T cells, allo-HSCT or anti-PD1 antibodies) have to be considered.
S Nalghranyan Amrit P. Singh Carolina Schinke, The combination of venetoclax, daratumumab and dexamethasone for the treatment of refractory primary plasma cell leukemia. Hematology Volume95, Issue2 February 2020 Pages E34-E35 Published:June 16, 2018DOI:https://doi.org/10.1016/j.clml.2018.06.003
Kian J. Rahbari et al, Venetoclax in Combination With Bortezomib, Dexamethasone, and Daratumumab for Multiple Myeloma. Clinical Lymphoma, Myeloma and Leukemia Volume 18, ISSUE 9, E339-E343,
CS CHim et al, Management of relapsed and refractory multiple myeloma:
novel agents, antibodies, immunotherapies and beyond Leukemia (2018) 32, 252262
Single agent venetoclax induces MRDnegative response in relapsed primary plasma cell leukemia with t[11;14] American Journal of Hematology 94(1) · October 2018