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A retrospective comparison of salvage intensive chemotherapy versus venetoclax-combined regimen in patients with relapsed/refractory acute myeloid leukemia (AML)

BACKGROUND: Evidence that a venetoclax (VEN)-combined regimen is effective in relapsed/refractory acute myeloid leukemia (R/R AML) is emerging. However, it is unknown how VEN-combined low intensity treatment compares to intensive chemotherapy (IC) in medically fit patients with R/R AML. METHODS: We...

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Detalles Bibliográficos
Autores principales: Park, Silvia, Kwag, Daehun, Kim, Tong Yoon, Lee, Jong Hyuk, Lee, Joon yeop, Min, Gi June, Park, Sung Soo, Yahng, Seung-Ah, Jeon, Young-Woo, Shin, Seung-Hwan, Yoon, Jae-Ho, Lee, Sung-Eun, Cho, Byung Sik, Eom, Ki-Seong, Kim, Yoo-Jin, Lee, Seok, Min, Chang-Ki, Cho, Seok-Goo, Lee, Jong Wook, Kim, Hee-Je
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8949776/
https://www.ncbi.nlm.nih.gov/pubmed/35340720
http://dx.doi.org/10.1177/20406207221081637
Descripción
Sumario:BACKGROUND: Evidence that a venetoclax (VEN)-combined regimen is effective in relapsed/refractory acute myeloid leukemia (R/R AML) is emerging. However, it is unknown how VEN-combined low intensity treatment compares to intensive chemotherapy (IC) in medically fit patients with R/R AML. METHODS: We compared AML patients who received IC (n = 89) to those who received a VEN in combination with hypomethylating agents or low dose cytarabine (VEN combination) (n = 54) as their first- or second-line salvage after failing anthracycline-containing intensive chemotherapy. RESULTS: The median age was 49 years, and significantly more patients in the VEN combination group were in their second salvage and had received prior stem cell transplantation (SCT). Overall response rates including CR, CRi, and MLFS were comparable (44.0% for IC vs. 59.3% for VEN combination, p = 0.081), but VEN combination group compared to IC group tended to show lower treatment related mortality. The rate of bridging to SCT was the same (68.5%), but the percentage of SCT at blast clearance was significantly higher in the VEN-combined group (62.3% vs. 86.5%, p = 0.010). After median follow-up periods of 22.5 (IC) and 11.3 months (VEN combination), the median overall survival was 8.9 (95% CI, 5.4-12.4) and 12.4 months (95% CI, 9.5-15.2) (p = 0.724), respectively. CONCLUSION: VEN combination provides a comparable anti-leukemic response and survival to salvage IC, and provide a bridge to SCT with better disease control in medically-fit patients with R/R AML.