Treatment of acute myeloid leukemia with active pulmonary tuberculosis with venetoclax‑based anti‑acute myeloid leukemia regimen combined with an intensive and then individualized anti‑tuberculosis regimen: A report of two cases

以维奈克拉为基础的抗急性髓系白血病方案联合强化及个体化抗结核治疗活动性肺结核急性髓系白血病2例

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作者:Lin Ji, Wei Yang, Liu Jie Gao, Bei Yuan Zhang, Ya Qing Xu, Xiao Feng Xu

Abstract

Patients with concurrent acute myeloid leukemia (AML) and active pulmonary tuberculosis (TB) exhibit certain characteristics; cough, phlegm, fever, hemoptysis, weight loss and dyspnea are common symptoms of both diseases. These patients often cannot tolerate traditional intensive chemotherapy regimens, and finding the optimal timing in the treatment of both AML and active pulmonary TB is complex. Neglecting timely treatment can lead to serious complications and even fatal outcomes. The present paper reports two cases of patients with AML who were diagnosed with active pulmonary TB. The patients received intensive anti-TB treatment with isoniazid, rifampicin, pyrazinamide and ethambutol for 10-15 days. After three consecutive negative sputum smears, the patients in cases 1 and 2 were treated with a venetoclax, homoharringtonine and cytarabine regimen; and a venetoclax and azacitidine regimen for anti-AML therapy, respectively, as well as individualized anti-TB regimens of isoniazid, pyrazinamide, ethambutol and quinolone. Subsequently, both patients achieved complete remission of AML and their active TB was well controlled.

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