DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.016

Pages: 1835-1837

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and highly aggressive hematologic malignancy that predominantly affects older adults. Owing to advanced age and multiple comorbidities, intensive chemotherapy is often not feasible, making therapeutic management particularly challenging. We report the case of a 76-year-old man with BPDCN who achieved a rapid and durable response to azacitidine combined with venetoclax despite the concomitant administration of voriconazole for antifungal prophylaxis. Complete remission with incomplete hematologic recovery (CRi) and cytogenetic normalization were achieved after the first treatment cycle. This case highlights the efficacy and favorable tolerability of hypomethylating agent–venetoclax therapy as a valuable therapeutic alternative for elderly patients ineligible for intensive treatment, while emphasizing the importance of appropriate venetoclax dose adjustment in the setting of concomitant CYP3A4 inhibition.