Venetoclax‐based non‐intensive induction followed by allogenic stem‐cell transplantation in elderly acute myeloid leukemia patients with adverse cytogenetics

医学 内科学 阿扎胞苷 移植 髓系白血病 威尼斯人 胃肠病学 白血病 队列 细胞遗传学 髓样 肿瘤科 外科 慢性淋巴细胞白血病 生物 基因表达 DNA甲基化 染色体 基因 生物化学
作者
Amel Soua,Julia Gilhodes,Alexandre Iat,Yosr Hicheri,Colombe Saillard,Camille Rouzaud,Evelyne D’Incan,Jérôme Rey,Bilal Mohty,Aude Charbonnier,Antoine Ittel,Anne‐Sophie Alary,Véronique Gelsi‐Boyer,Anne Murati,Anne‐Catherine Lhoumeau,Raynier Devillier,Jean‐Marie Boher,Julien Mozziconacci,Norbert Vey,Marie‐Anne Hospital,Sylvain Garciaz
出处
期刊:European Journal of Haematology [Wiley]
标识
DOI:10.1111/ejh.14290
摘要

Abstract Introduction Elderly acute myeloid leukemia (AML) patients with poor‐risk cytogenetics have a poor outcome with intensive chemotherapy (IC). While Venetoclax (VEN) has changed the outcomes of elderly unfit patients treatment, it is unknown whether it could be effective in poor‐risk cytogenetics 60–75 years old patients. Materials and Methods We included 60–75‐year‐old AML patients eligible to allogenic stem cell transplantation (allo‐SCT) treated with VEN (combined with azacitidine or with Cladribin and Aracytine) at Institut Paoli Calmettes, between 2020 and 2023 and compared this cohort with patients treated by IC between 2010 and 2019. Results Twenty six patients were treated with VEN (17 in combination with azacitidine and 9 with Cladribin and Aracytine) and 90 were treated with IC. Thirteen patients (50%) had a TP53 mutation. The median time for leucocyte and platelet counts recovery was 26 days (range 0–103) and 26 days (range, 0–63). The median duration of the first hospitalization was 32 days (ranges, 7–79). The composite response rate was 69% (CR = 50%, CRi = 4%, MLFS = 15%). Allo‐SCT could be performed in 42% of cases. Median overall survival (OS) was 7.9 months (20.9 months in the group of patients who transitioned to allo‐SCT). We found no difference with the historical cohort of patients treated with IC except a trend toward less lower and upper tract gastro‐intestinal (GI) tract infections in the VEN group (respectively 8% vs 26%, p = .06; and 0% vs. 13% p = .06). Conclusion VEN‐based treatment was found to be effective in high risk AML can be considered as an alternative to IC in patients aged 60–75 with adverse cytogenetics.
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