Efficacy and Prognosis of Venetoclax Combined with Hypomethylating Agents in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia

Lan Li, Weihua Zhang
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Abstract

Objective: To investigate the efficacy and prognosis of venetoclax combined with hypomethylating agents (HMAs) in the treatment of relapsed/refractory acute myeloid leukemia (AML). Methods: From June 2021 to February 2022, 14 patients with relapsed/refractory AML were treated with venetoclax combined with HMAs, among which nine patients were treated with venetoclax + azacytidine, while five patients were treated with venetoclax + decitabine. The efficacy of the treatments was observed, and the patients were followed up. Results: All patients received one to five courses of treatment, in which the median course of treatment was three; four cases achieved CR and another four achieved PR, with NR in six cases; there was no treatment-related death. There were seven deaths up to the end of the follow-up period, all of which were progressive deaths at the end of the disease, and the overall survival rate was 50.00%. All the patients experienced different degrees of nausea, vomiting, and myelosuppression (Grade II–IV), nine patients had Grade 3–4 hematological adverse reactions, and seven patients had infection. Conclusion: Venetoclax combined with hypomethylating agents is effective in the treatment of relapsed/refractory AML, with good prognosis, and some patients may even achieve CR. Although bone marrow suppression is serious with this combination, it is well tolerated.
Venetoclax联合低甲基化药物治疗复发/难治性急性髓系白血病的疗效和预后
目的:探讨维妥乐联合低甲基化药物(HMAs)治疗复发/难治性急性髓系白血病(AML)的疗效和预后。方法:从2021年6月至2022年2月,对14例复发/难治性AML患者采用venetoclax联合HMAs治疗,其中venetoclax +阿扎胞苷治疗9例,venetoclax +地西他滨治疗5例。观察治疗效果,并对患者进行随访。结果:所有患者均接受1 ~ 5个疗程的治疗,其中中位疗程为3个疗程;CR 4例,PR 4例,NR 6例;没有治疗相关的死亡。随访结束时死亡7例,均为疾病末期进行性死亡,总生存率为50.00%。所有患者均出现不同程度的恶心、呕吐、骨髓抑制(II-IV级),9例发生3-4级血液不良反应,7例发生感染。结论:Venetoclax联合低甲基化药物治疗复发/难治性AML有效,预后良好,部分患者甚至可达到CR,虽然联合用药骨髓抑制严重,但耐受性良好。
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