venetoclax联合FLAG-IDA诱导和巩固治疗新诊断和复发或难治性急性髓性白血病的长期结果

IF 12.8 1区医学 Q1 HEMATOLOGY

Leukemia Pub Date : 2025-02-25 DOI:10.1038/s41375-025-02531-8

Courtney D. DiNardo, Wei-Ying Jen, Koichi Takahashi, Tapan M. Kadia, Sanam Loghavi, Naval G. Daver, Lianchun Xiao, Patrick K. Reville, Ghayas C. Issa, Nicholas J. Short, Koji Sasaki, Sa A. Wang, Jillian K. Mullin, Sherry Pierce, Corey Bradley, Gautam Borthakur, Abhishek Maiti, Yesid Alvarado, Naveen Pemmaraju, Alessandra Ferrajoli, Mahesh Swaminathan, Maro Ohanian, Hussein A. Abbas, Danielle Hammond, Jan Burger, Fadi Haddad, Guillermo Montalban-Bravo, Kelly Chien, Lucia Masarova, Musa Yilmaz, Nitin Jain, Michael Andreeff, Guillermo Garcia-Manero, Steven Kornblau, Farhad Ravandi, Elias Jabbour, Marina Y. Konopleva, Hagop M. Kantarjian

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引用次数: 0

摘要

强化化疗仍然是新诊断急性髓性白血病（AML）的标准；然而，复发的风险仍然很高。此外，大多数复发/难治性AML （RR）患者预后较差。我们报告了138例患者的长期经验，77例ND和61例RR，使用FLAG-IDA联合venetoclax治疗。在ND队列中，总缓解率（ORR）为97%，复合完全缓解（CRc）率为95%，流式细胞术检测不到的残留疾病（MRD）状态为90%。3年OS和EFS分别为66%和64%。欧洲白血病网（ELN） 2022风险组的结果相似。在CR1中，64%的人转向了同种异体造血干细胞移植（allo-SCT）。在RR队列中，ORR为67%；CRc率41%，血流阴性MRD率74%；57%的患者转移到全细胞移植。具有野生型TP53状态的首次抢救的RR AML患者具有特别有利的结果，ORR为79%，CRc率为74%（76%的MRD未检测到），3年OS率为51%。感染和血液学不良事件很常见，与其他强化化疗方案相似，30天和60天的死亡率较低。FLAG-IDA + VEN对ND和RR aml的缓解诱导均有效

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$Long term results of venetoclax combined with FLAG-IDA induction and consolidation for newly diagnosed and relapsed or refractory acute myeloid leukemia$

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Long term results of venetoclax combined with FLAG-IDA induction and consolidation for newly diagnosed and relapsed or refractory acute myeloid leukemia

Intensive chemotherapy remains the standard for newly diagnosed (ND) acute myeloid leukemia (AML); however, relapse risk remains high. Additionally, most patients with relapsed/refractory (RR) AML have poor outcomes. We report the long-term experience of 138 patients, 77 ND and 61 RR, treated with FLAG-IDA in combination with venetoclax. In the ND cohort, the overall response rate (ORR) was 97%, with a composite complete remission (CRc) rate of 95% and undetectable measurable residual disease (MRD) status by flow cytometry in 90%. The 3-year OS and EFS rates were 66 and 64%, respectively. Outcomes were similar across European LeukemiaNet (ELN) 2022 risk groups. Sixty-four percent transitioned to allogeneic hematopoietic stem cell transplantation (allo-SCT) in CR1. In the RR cohort, the ORR was 67%; CRc rate 41% and flow negative MRD rate 74%; 57% transitioned to allo-SCT. The patients with RR AML in first salvage with wild-type TP53 status had particularly favorable outcomes, with an ORR of 79%, CRc rate of 74% (76% MRD undetectable) and 3-year OS rate of 51%. Infectious and hematologic adverse events were common, with low 30- and 60-day mortality similar to other intensive chemotherapy regimens. FLAG-IDA + VEN is effective for remission induction in both ND and RR AML. ClinicalTrials.gov Identifier: NCT03214562

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来源期刊

Leukemia 医学-血液学

CiteScore

18.10

自引率

3.50%

发文量

270

审稿时长

3-6 weeks

期刊介绍： Title: Leukemia Journal Overview: Publishes high-quality, peer-reviewed research Covers all aspects of research and treatment of leukemia and allied diseases Includes studies of normal hemopoiesis due to comparative relevance Topics of Interest: Oncogenes Growth factors Stem cells Leukemia genomics Cell cycle Signal transduction Molecular targets for therapy And more Content Types: Original research articles Reviews Letters Correspondence Comments elaborating on significant advances and covering topical issues