Cargando…

Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study

There is a deficiency of real-world data on the impact of combining venetoclax (VEN) with hypomethylating agents (HMAs) in newly diagnosed acute myeloid leukemia (AML) patients. We conducted a single-center, propensity-adjusted retrospective cohort study to compare composite complete remission (CCR)...

Descripción completa

Detalles Bibliográficos
Autores principales: Mustafa Ali, Moaath K., Corley, Elizabeth M., Alharthy, Hanan, Kline, Kathryn A. F., Law, Jennie Y., Lee, Seung Tae, Niyongere, Sandrine, Duong, Vu H., Emadi, Ashkan, Baer, Maria R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008336/
https://www.ncbi.nlm.nih.gov/pubmed/35433414
http://dx.doi.org/10.3389/fonc.2022.858202
_version_ 1784687029818228736
author Mustafa Ali, Moaath K.
Corley, Elizabeth M.
Alharthy, Hanan
Kline, Kathryn A. F.
Law, Jennie Y.
Lee, Seung Tae
Niyongere, Sandrine
Duong, Vu H.
Emadi, Ashkan
Baer, Maria R.
author_facet Mustafa Ali, Moaath K.
Corley, Elizabeth M.
Alharthy, Hanan
Kline, Kathryn A. F.
Law, Jennie Y.
Lee, Seung Tae
Niyongere, Sandrine
Duong, Vu H.
Emadi, Ashkan
Baer, Maria R.
author_sort Mustafa Ali, Moaath K.
collection PubMed
description There is a deficiency of real-world data on the impact of combining venetoclax (VEN) with hypomethylating agents (HMAs) in newly diagnosed acute myeloid leukemia (AML) patients. We conducted a single-center, propensity-adjusted retrospective cohort study to compare composite complete remission (CCR) rates, median overall survival (m-OS) and median event-free survival (m-EFS). A total of 170 adult AML patients were treated with first-line azacitidine (AZA) or decitabine (DEC) +/- VEN. Median age was 71 years and 99 (58%) were male. Median follow-up in HMA and HMA-VEN groups was 79 and 21 months. Treatments included AZA alone (n=35, 21%), DEC alone (n=84, 49%), AZA-VEN (n=24, 14%) and DEC-VEN (n=27, 16%). VEN improved CCR rates to HMAs overall (52% vs. 27%, P<0.05) and to AZA (54% vs. 10%, P<0.05), but not to DEC (43% vs. 32%, P=0.35); it did not improve OS, and only improved EFS for AZA (10.5 vs. 3.8 months, P<0.05). CCR rates were lower with AZA than with DEC (13% vs. 33%, P<0.05), but OS and EFS were not different statistically. CCR rates did not differ for AZA-VEN vs. DEC-VEN (CCR: 58% vs. 52%, P=0.66), but OS and EFS were longer for AZA-VEN (m-OS: 12.3 vs. 2.2 months, P<0.05; m-EFS: 9.2 vs. 2.1 months, P<0.05). Our analysis showed that combining VEN with AZA in newly diagnosed AML patients improved outcomes, but combining VEN with DEC did not. AZA-VEN was associated with improved outcomes compared to DEC-VEN. Further studies are needed to test the benefit of combining VEN with DEC.
format Online
Article
Text
id pubmed-9008336
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-90083362022-04-15 Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study Mustafa Ali, Moaath K. Corley, Elizabeth M. Alharthy, Hanan Kline, Kathryn A. F. Law, Jennie Y. Lee, Seung Tae Niyongere, Sandrine Duong, Vu H. Emadi, Ashkan Baer, Maria R. Front Oncol Oncology There is a deficiency of real-world data on the impact of combining venetoclax (VEN) with hypomethylating agents (HMAs) in newly diagnosed acute myeloid leukemia (AML) patients. We conducted a single-center, propensity-adjusted retrospective cohort study to compare composite complete remission (CCR) rates, median overall survival (m-OS) and median event-free survival (m-EFS). A total of 170 adult AML patients were treated with first-line azacitidine (AZA) or decitabine (DEC) +/- VEN. Median age was 71 years and 99 (58%) were male. Median follow-up in HMA and HMA-VEN groups was 79 and 21 months. Treatments included AZA alone (n=35, 21%), DEC alone (n=84, 49%), AZA-VEN (n=24, 14%) and DEC-VEN (n=27, 16%). VEN improved CCR rates to HMAs overall (52% vs. 27%, P<0.05) and to AZA (54% vs. 10%, P<0.05), but not to DEC (43% vs. 32%, P=0.35); it did not improve OS, and only improved EFS for AZA (10.5 vs. 3.8 months, P<0.05). CCR rates were lower with AZA than with DEC (13% vs. 33%, P<0.05), but OS and EFS were not different statistically. CCR rates did not differ for AZA-VEN vs. DEC-VEN (CCR: 58% vs. 52%, P=0.66), but OS and EFS were longer for AZA-VEN (m-OS: 12.3 vs. 2.2 months, P<0.05; m-EFS: 9.2 vs. 2.1 months, P<0.05). Our analysis showed that combining VEN with AZA in newly diagnosed AML patients improved outcomes, but combining VEN with DEC did not. AZA-VEN was associated with improved outcomes compared to DEC-VEN. Further studies are needed to test the benefit of combining VEN with DEC. Frontiers Media S.A. 2022-03-31 /pmc/articles/PMC9008336/ /pubmed/35433414 http://dx.doi.org/10.3389/fonc.2022.858202 Text en Copyright © 2022 Mustafa Ali, Corley, Alharthy, Kline, Law, Lee, Niyongere, Duong, Emadi and Baer https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Mustafa Ali, Moaath K.
Corley, Elizabeth M.
Alharthy, Hanan
Kline, Kathryn A. F.
Law, Jennie Y.
Lee, Seung Tae
Niyongere, Sandrine
Duong, Vu H.
Emadi, Ashkan
Baer, Maria R.
Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title_full Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title_fullStr Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title_full_unstemmed Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title_short Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study
title_sort outcomes of newly diagnosed acute myeloid leukemia patients treated with hypomethylating agents with or without venetoclax: a propensity score-adjusted cohort study
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9008336/
https://www.ncbi.nlm.nih.gov/pubmed/35433414
http://dx.doi.org/10.3389/fonc.2022.858202
work_keys_str_mv AT mustafaalimoaathk outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT corleyelizabethm outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT alharthyhanan outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT klinekathrynaf outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT lawjenniey outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT leeseungtae outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT niyongeresandrine outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT duongvuh outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT emadiashkan outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy
AT baermariar outcomesofnewlydiagnosedacutemyeloidleukemiapatientstreatedwithhypomethylatingagentswithorwithoutvenetoclaxapropensityscoreadjustedcohortstudy