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维奈托克联合低甲基化药物治疗既往未接受过治疗且不符合强化治疗条件的急性髓系白血病患者:一项真实世界多中心经验

Venetoclax in combination with hypomethylating agents in previously untreated patients with acute myeloid leukemia ineligible for intensive treatment: a real-life multicenter experience.

作者信息

De Bellis Eleonora, Imbergamo Silvia, Candoni Anna, Liço Albana, Tanasi Ilaria, Mauro Endri, Mosna Federico, Leoncin Matteo, Stulle Manuela, Griguolo Davide, Pravato Stefano, Trentin Livio, Lazzarotto Davide, Di Bona Eros, Bassan Renato, Lucchini Elisa, Poiani Monica, Palmieri Clara, Zaja Francesco

机构信息

Hematology Unit, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy; Department of Biomedicine and Prevention, PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy.

Hematology Section, Department of Medicine, Azienda Ospedale Università Padova, Italy.

出版信息

Leuk Res. 2022 Mar;114:106803. doi: 10.1016/j.leukres.2022.106803. Epub 2022 Feb 8.

Abstract

The addition of venetoclax to hypomethylating agents (HMA-V) improved the outcome of patients with newly diagnosed acute myeloid leukemia (AML) ineligible for intensive treatment. The aim of our study was to confirm data reported in literature, in a real-life multicenter experience. We retrospectively evaluated 56 naïve AML patients who received HMA-V at 8 different collaborating Hematology Units in the North-East of Italy, from September 2018 to October 2020. Patients received azacitidine or decitabine at standard dose, adding venetoclax starting from cycle 1-3. The median time-to-response was 2 cycles and composite complete remission rate (CCR) was 67.9%. Thirteen out of 38 responders (34.2%) relapsed, with a median response duration of 13.7 months. Transfusion independence (TI) was obtained in 27 (87.0%) and 28 (90.3%) out of 31 patients for red blood cells and platelets, respectively. Median OS was 12.3 months (95% CI, 8.1-16.5), and median PFS was 11.3 months (95% CI, 4.6-17.9). Cytogenetic risk was the only variable impacting on survival, while no differences were observed stratifying patients by age, bone marrow blasts, WHO classification or type of HMA. In conclusion, our real-life multicenter experience indicates that HMA-V treatment allows achieving good response rates in naïve AML patients, ineligible for intensive chemotherapy.

摘要

将维奈克拉添加到低甲基化药物(HMA-V)中可改善新诊断的不符合强化治疗条件的急性髓系白血病(AML)患者的预后。我们研究的目的是在真实的多中心经验中证实文献报道的数据。我们回顾性评估了2018年9月至2020年10月期间在意大利东北部8个不同协作血液学单位接受HMA-V治疗的56例初治AML患者。患者接受标准剂量的阿扎胞苷或地西他滨,并从第1-3周期开始添加维奈克拉。中位缓解时间为2个周期,综合完全缓解率(CCR)为67.9%。38例缓解者中有13例(34.2%)复发,中位缓解持续时间为13.7个月。31例患者中,分别有27例(87.0%)和28例(90.3%)实现了红细胞和血小板的输血独立性(TI)。中位总生存期(OS)为12.3个月(95%CI,8.1-16.5),中位无进展生存期(PFS)为11.3个月(95%CI,4.6-17.9)。细胞遗传学风险是影响生存的唯一变量,而按年龄、骨髓原始细胞、WHO分类或HMA类型对患者进行分层时未观察到差异。总之,我们的真实多中心经验表明,HMA-V治疗可使不符合强化化疗条件的初治AML患者获得良好的缓解率。

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