Sequential Treatment with Venetoclax and Donor Lymphocyte Infusions

Overview

This case study reports the treatment of a patient with high-risk myelodysplastic syndrome (MDS) who relapsed after allogeneic stem cell transplantation (allo-HSCT). The patient achieved complete remission (CR) for 24 months following a treatment strategy combining azacitidine, low-dose venetoclax, and donor lymphocyte infusion.

Background

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only potentially curative therapy for high-risk MDS and acute myeloid leukemia (AML). Post-transplant relapse remains a significant challenge, often leading to poor outcomes. The combination of hypomethylating agents and venetoclax has emerged as a potential strategy for managing these relapses, although its long-term effectiveness is still under investigation.

Data Highlights

No numerical data or trial data provided in the source material.

Key Findings

• The patient was treated with azacitidine and low-dose venetoclax, resulting in restored bone marrow cellularity and improved hematological parameters.
• After the initial course of treatment, the patient achieved full chimerism.
• Subsequent courses of azacitidine/venetoclax were supplemented with donor lymphocyte infusion (DLI).
• The patient maintained complete remission for 24 months following treatment.
• The treatment strategy was effective in disease control and did not lead to infectious complications.

Clinical Implications

The combination of azacitidine and venetoclax, followed by DLI, may offer a treatment option for patients with high-risk MDS who experience relapse after allo-HSCT.

Conclusion

This case study highlights a sequential treatment strategy involving venetoclax and DLI for managing relapse in high-risk MDS post-allo-HSCT.

Related Resources & Content

1. Blood Cancer Journal, 2021 -- Salvage use of venetoclax-based therapy for relapsed AML post allogeneic hematopoietic cell transplantation
2. Frontiers in Immunology, 2026 -- Venetoclax combined with chidamide and decitabine successfully induced remission in relapsed/refractory classical Hodgkin lymphoma: a case report and literature review
3. Blood Cancer Journal, 2021 -- Combination of Venetoclax with Low-Dose Cytarabine Achieves Significant Remission in Acute Myeloid Leukemia by Targeting Leukemic Stem Cells and Altering Clonal Hematopoiesis
4. Bone Marrow Transplantation, 2021 -- Efficacy of Venetoclax and Actinomycin D in Treating Relapsed Acute Myeloid Leukemia Following Allogeneic Hematopoietic Cell Transplantation
5. How I treat AML relapse after allogeneic HSCT - ScienceDirect
6. Venetoclax plus hypomethylating agents as first salvage therapy for myeloid malignancies relapsing after allogeneic HSCT | Bone Marrow Transplantation
7. 2025 Update on MRD in Acute Myeloid Leukemia: A Consensus Document from the ELN-DAVID MRD Working Party - ScienceDirect
8. How I treat AML relapse after allogeneic HSCT - ScienceDirect
9. Venetoclax plus hypomethylating agents as first salvage therapy for myeloid malignancies relapsing after allogeneic HSCT | Bone Marrow Transplantation
10. 2025 Update on MRD in Acute Myeloid Leukemia: A Consensus Document from the ELN-DAVID MRD Working Party - ScienceDirect