Impact of previous anthracycline therapy in patients with acute myeloid leukemia receiving venetoclax

Venetoclax (VEN) combination regimens are now recognized as effective against acute myeloid leukemia (AML). However, the prognosis of patients who do not attain a composite complete response (cCR) is extremely poor, and clinical determinants of response remain unknown. Medical records of 57 patients...

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Bibliographic Details
Published in:International journal of hematology 2023-12, Vol.118 (6), p.711-717
Main Authors: Hara, Ryujiro, Machida, Shinichiro, Hashimoto, Norisato, Ogiya, Daisuke, Kawai, Hidetsugu, Kawakami, Shohei, Shiraiwa, Sawako, Onizuka, Makoto, Ogawa, Yoshiaki, Kawada, Hiroshi, Ando, Kiyoshi
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
Allografts
Anthracycline
Chemotherapy
Cytarabine
Cytogenetics
Health services
Hematology
Hematopoietic stem cells
Leukemia
Medical records
Medicine
Medicine & Public Health
Multivariate analysis
Oncology
Original Article
Patients
Remission
Remission (Medicine)
Stem cell transplantation
Stem cells
Transplantation
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Summary:Venetoclax (VEN) combination regimens are now recognized as effective against acute myeloid leukemia (AML). However, the prognosis of patients who do not attain a composite complete response (cCR) is extremely poor, and clinical determinants of response remain unknown. Medical records of 57 patients with AML treated with VEN combination regimens from April 2021 to March 2022 at six institutions were retrospectively analyzed. The primary endpoint was cCR, complete remission, or complete remission with incomplete hematologic recovery after one cycle of VEN combination regimen. Five patients had previously relapsed after allogeneic hematopoietic stem cell transplantation (allo-SCT). The treatment regimen was azacitidine–VEN in 48 patients (84%) and low-dose cytarabine–VEN in 9 patients (16%). Thirty patients (53%) achieved cCR after one cycle of a VEN regimen. In univariate analysis, the number of prior chemotherapy regimens, post-allo-SCT relapse, and cytogenetic risk category were associated with a decreased likelihood of achieving cCR. In multivariate analysis, second-line chemotherapy remained a significant predictor of response. Patients who received anthracycline immediately before the VEN regimen had a higher cCR rate than patients who did not receive anthracycline. In this study, prior chemotherapy/allo-SCT and cytogenetic risk were associated with VEN treatment outcomes.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-023-03664-1