Venetoclax for an ATRA and ATO resistance acute promyelocytic leukemia patient with TNRC18::RARA fusion gene

Variant acute promyelocytic leukemia (APL) poses diagnostic and therapeutic challenges primarily because of the absence of PML::RARA. This report presents the case of a patient diagnosed with all-trans retinoic acid (ATRA)-resistant APL harboring the TNRC18::RARA fusion gene. After treatment with venetoclax, azacitidine, and ATRA, the patient achieved complete remission. The patient also developed pulmonary tuberculosis and a multidrug-resistant infection, which improved considerably after antituberculosis treatment and carrimycin, respectively.