Effects of Venetoclax Combined with Azacitidine on the Immune Function and Quality of Life in Patients with Relapsed Acute Myeloid Leukemia.

Abstract

Aims/Background Patients with relapsed acute myeloid leukemia (AML) have a poor prognosis and limited treatment options. The combination of azacitidine and venetoclax has demonstrated some efficacy in relapsed AML. This study aimed to investigate the effects of venetoclax combined with azacitidine on immune function and quality of life in patients with relapsed AML. Methods This study retrospectively analyzed the clinical data of 104 patients with relapsed AML who were admitted to the First People's Hospital of Fuyang from January 2020 to January 2024. The patients were divided into a combination group (n = 53, treated with a combination of venetoclax and azacitidine) and an azacitidine group (n = 51, treated with azacitidine) according to the treatment protocol. Hematological parameters (proportion of bone marrow progenitor cells [PBMPC], white blood cell count [WBC], platelet count [PLT], neutrophil count [NEUT], and hemoglobin [Hb]), serum immunoglobulin (immunoglobulin G [IgG], IgA, and IgM) and inflammatory factor (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) levels, as well as European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) scores were compared between the two groups, and adverse reactions were recorded. Results The remission rate in the combination group (66.0%) was significantly higher than that in the azacitidine group (45.1%, p < 0.05). Both azacitidine monotherapy and the combination therapy with venetoclax improved hematological indicators and quality of life while reducing serum immunoglobulin levels and inflammatory factors. Compared with the azacitidine group, the combination group demonstrated a significant reduction in PBMPC (p < 0.05), alongside an increase in WBC, PLT, NEUT, and Hb (p < 0.05). Additionally, combination therapy led to a greater reduction in serum levels of IgG, IgA, IgM, IL-6, and TNF-α compared to azacitidine alone (p < 0.05). Moreover, combination therapy significantly improved scores for physical, emotional, cognitive, social function, and general health status (p < 0.05), while reducing scores for nausea, dyspnea, insomnia, pain, and constipation (p < 0.05). Importantly, there was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). Conclusion The combination of venetoclax and azacitidine could regulate the immune function, improve hematological indicators and quality of life, without increasing the incidence of adverse reactions in patients with relapsed AML.