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Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation

This study aimed to evaluate the efficacy and safety of venetoclax plus azacitidine and donor lymphocyte infusion (DLI) in treating patients with relapsed acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twenty-six AML patients who relapsed after all...

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Autores principales: Zhao, Peng, Ni, Ming, Ma, Dan, Fang, Qin, Zhang, Yan, Li, Yanju, Huang, Yi, Chen, Ying, Chai, Xiao, Zhan, Yun, Li, Yan, Kang, Qian, Zhao, Mei, Liu, Min, Zhang, Fengqi, Huang, Shisi, Wen, Shuangshuang, Deng, Bo, Wang, Jishi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720738/
https://www.ncbi.nlm.nih.gov/pubmed/34568973
http://dx.doi.org/10.1007/s00277-021-04674-x
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author Zhao, Peng
Ni, Ming
Ma, Dan
Fang, Qin
Zhang, Yan
Li, Yanju
Huang, Yi
Chen, Ying
Chai, Xiao
Zhan, Yun
Li, Yan
Kang, Qian
Zhao, Mei
Liu, Min
Zhang, Fengqi
Huang, Shisi
Wen, Shuangshuang
Deng, Bo
Wang, Jishi
author_facet Zhao, Peng
Ni, Ming
Ma, Dan
Fang, Qin
Zhang, Yan
Li, Yanju
Huang, Yi
Chen, Ying
Chai, Xiao
Zhan, Yun
Li, Yan
Kang, Qian
Zhao, Mei
Liu, Min
Zhang, Fengqi
Huang, Shisi
Wen, Shuangshuang
Deng, Bo
Wang, Jishi
author_sort Zhao, Peng
collection PubMed
description This study aimed to evaluate the efficacy and safety of venetoclax plus azacitidine and donor lymphocyte infusion (DLI) in treating patients with relapsed acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twenty-six AML patients who relapsed after allo-HSCT were enrolled and treated with venetoclax plus azacitidine and DLI. Complete remission with incomplete recovery (CRi), partial remission (PR), and objective remission rate (ORR) were assessed, and then event-free survival (EFS) and overall survival (OS) were evaluated. Besides, adverse events were documented. Additionally, whole exome sequencing was performed in bone marrow samples. The CRi, PR, and ORR rates were 26.9%, 34.6%, and 61.5%, respectively. The median time of EFS and OS was 120 (95% CI: 71–610) days and 284.5 (95% CI: 81–610) days, respectively. The most common adverse events were hematologic system adverse events including agranulocytosis, anemia, and thrombocytopenia, while the adverse events of other systems were relatively less and milder. In addition, no serious adverse events existed. Of note, there were 6 (23.1%) patients who developed GVHD. As for gene mutation, 49 mutated genes were found, which were categorized as first-, second-, and third-class mutations, and then further analysis revealed that the first-class mutations were not correlated with EFS or OS. Additionally, the most frequent mutated genes were FLT3, CEBPA, DNMT3A, KIT, KRAS, and NRAS. Venetoclax plus azacitidine and DLI is efficient and tolerant in treating patients with relapsed AML after allo-HSCT, implying this combined therapy as a potential treatment option in the studied patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-021-04674-x.
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spelling pubmed-87207382022-01-13 Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation Zhao, Peng Ni, Ming Ma, Dan Fang, Qin Zhang, Yan Li, Yanju Huang, Yi Chen, Ying Chai, Xiao Zhan, Yun Li, Yan Kang, Qian Zhao, Mei Liu, Min Zhang, Fengqi Huang, Shisi Wen, Shuangshuang Deng, Bo Wang, Jishi Ann Hematol Original Article This study aimed to evaluate the efficacy and safety of venetoclax plus azacitidine and donor lymphocyte infusion (DLI) in treating patients with relapsed acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twenty-six AML patients who relapsed after allo-HSCT were enrolled and treated with venetoclax plus azacitidine and DLI. Complete remission with incomplete recovery (CRi), partial remission (PR), and objective remission rate (ORR) were assessed, and then event-free survival (EFS) and overall survival (OS) were evaluated. Besides, adverse events were documented. Additionally, whole exome sequencing was performed in bone marrow samples. The CRi, PR, and ORR rates were 26.9%, 34.6%, and 61.5%, respectively. The median time of EFS and OS was 120 (95% CI: 71–610) days and 284.5 (95% CI: 81–610) days, respectively. The most common adverse events were hematologic system adverse events including agranulocytosis, anemia, and thrombocytopenia, while the adverse events of other systems were relatively less and milder. In addition, no serious adverse events existed. Of note, there were 6 (23.1%) patients who developed GVHD. As for gene mutation, 49 mutated genes were found, which were categorized as first-, second-, and third-class mutations, and then further analysis revealed that the first-class mutations were not correlated with EFS or OS. Additionally, the most frequent mutated genes were FLT3, CEBPA, DNMT3A, KIT, KRAS, and NRAS. Venetoclax plus azacitidine and DLI is efficient and tolerant in treating patients with relapsed AML after allo-HSCT, implying this combined therapy as a potential treatment option in the studied patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-021-04674-x. Springer Berlin Heidelberg 2021-09-27 2022 /pmc/articles/PMC8720738/ /pubmed/34568973 http://dx.doi.org/10.1007/s00277-021-04674-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Zhao, Peng
Ni, Ming
Ma, Dan
Fang, Qin
Zhang, Yan
Li, Yanju
Huang, Yi
Chen, Ying
Chai, Xiao
Zhan, Yun
Li, Yan
Kang, Qian
Zhao, Mei
Liu, Min
Zhang, Fengqi
Huang, Shisi
Wen, Shuangshuang
Deng, Bo
Wang, Jishi
Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title_full Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title_fullStr Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title_full_unstemmed Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title_short Venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
title_sort venetoclax plus azacitidine and donor lymphocyte infusion in treating acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720738/
https://www.ncbi.nlm.nih.gov/pubmed/34568973
http://dx.doi.org/10.1007/s00277-021-04674-x
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