Outcomes of Newly Diagnosed Acute Myeloid Leukemia Patients Treated With Hypomethylating Agents With or Without Venetoclax: A Propensity Score-Adjusted Cohort Study

Frontiers in Oncology

Sandrine Niyongere¹  Hanan Alharthy¹  Maria R. Baer¹  Moaath K. Mustafa Ali¹  Seung Tae Lee¹  Vu H. Duong¹  Kathryn A. F. Kline¹  Jennie Y. Law¹  Elizabeth M. Corley⁴  Ashkan Emadi⁵ 

[1] Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, United States;Department of Pharmacology, University of Maryland School of Medicine, Baltimore, MD, United States;Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, United States;School of Medicine, University of Maryland, Baltimore, MD, United States;Translational Genomics Laboratory, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, United States;

关键词: acute myeloid leukemia;    azacitidine;    decitabine (451668);    venetoclax (ABT-199);    outcomes;    overall survival (OS);   

DOI  :  10.3389/fonc.2022.858202

来源: DOAJ

【 摘 要 】

There is a deficiency of real-world data on the impact of combining venetoclax (VEN) with hypomethylating agents (HMAs) in newly diagnosed acute myeloid leukemia (AML) patients. We conducted a single-center, propensity-adjusted retrospective cohort study to compare composite complete remission (CCR) rates, median overall survival (m-OS) and median event-free survival (m-EFS). A total of 170 adult AML patients were treated with first-line azacitidine (AZA) or decitabine (DEC) +/- VEN. Median age was 71 years and 99 (58%) were male. Median follow-up in HMA and HMA-VEN groups was 79 and 21 months. Treatments included AZA alone (n=35, 21%), DEC alone (n=84, 49%), AZA-VEN (n=24, 14%) and DEC-VEN (n=27, 16%). VEN improved CCR rates to HMAs overall (52% vs. 27%, P<0.05) and to AZA (54% vs. 10%, P<0.05), but not to DEC (43% vs. 32%, P=0.35); it did not improve OS, and only improved EFS for AZA (10.5 vs. 3.8 months, P<0.05). CCR rates were lower with AZA than with DEC (13% vs. 33%, P<0.05), but OS and EFS were not different statistically. CCR rates did not differ for AZA-VEN vs. DEC-VEN (CCR: 58% vs. 52%, P=0.66), but OS and EFS were longer for AZA-VEN (m-OS: 12.3 vs. 2.2 months, P<0.05; m-EFS: 9.2 vs. 2.1 months, P<0.05). Our analysis showed that combining VEN with AZA in newly diagnosed AML patients improved outcomes, but combining VEN with DEC did not. AZA-VEN was associated with improved outcomes compared to DEC-VEN. Further studies are needed to test the benefit of combining VEN with DEC.

【 授权许可】

Unknown