The efficacy and safety of venetoclax and azacytidine combination treatment in patients with acute myeloid leukemia and myelodysplastic syndrome: systematic review and meta-analysis

医学 内科学 中性粒细胞减少症 随机对照试验 科克伦图书馆 髓系白血病 骨髓增生异常综合症 阿扎胞苷 不利影响 荟萃分析 威尼斯人 养生 发热性中性粒细胞减少症 置信区间 白血病 肿瘤科 胃肠病学 化疗 骨髓 慢性淋巴细胞白血病 DNA甲基化 化学 基因表达 基因 生物化学
作者
Yufeng Du,Chunhong Li,Jinsong Yan
出处
期刊:Hematology [Informa]
卷期号:28 (1) 被引量:7
标识
DOI:10.1080/16078454.2023.2198098
摘要

The meta-analysis sought to evaluate the efficacy and safety of a combination of venetoclax (Ven) and azacitidine (AZA) in the treatment of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).We searched PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, and Web of Science for eligible studies from inception to June 2022. We used the Cochrane Risk of Bias 2.0 (RoB 2.0) and Methodological Index for Non-Randomized Studies (MINORS) to evaluate the quality of the included literature. The inverse variance method was used to calculate the pooled proportion and 95% confidence interval (CI).The meta-analysis included nineteen studies with a total of 1615 patients. The pooled overall CR/CRi (complete response (CR)/complete response with incomplete blood count recovery (CRi)) rate for AML and MDS was 57.9% (95% CI 49.5-65.9%, I2 = 83%). Subgroup analyses showed that the rate of pooled CR/CRi was 67.5% (95% CI 61.1-73.3%, I2 = 54%) for the new-diagnosed (ND) AML group, 30% (95% CI 20-44.1%, I2 = 66%) for relapsed/refractory (R/R) AML, and 67.6% (95% CI 52.6-79.8%, I2 = 65%) for MDS, respectively. One randomized controlled trial (RCT) showed that CR/CRi was 64.7% in ND-AML patients. A total of 9 studies reported adverse events, with neutropenia being the most common of grade 3-4 adverse events, with a rate of 53.7% (95% CI 61.1-73.3%, I2 = 54%).The present meta-analysis demonstrated that the Ven + AZA regimen is efficacious for the treatment of AML and MDS, with it being more effective for ND-AML than R/R AML. The most common adverse effects of this regimen are grade 3-4 neutropenia and neutropenia with fever.
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