Department of Hematology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Zhejiang Provincial Key Laboratory of Hematopoietic Malignancy, Zhejiang University, Hangzhou, Zhejiang, China.
Hematol Oncol. 2024 Mar;42(2):e3260. doi: 10.1002/hon.3260.
Venetoclax plus 3 + 7 daunorubicin and cytarabine chemotherapy (DAV) has shown safety and efficacy in eligible patients with newly diagnosed acute myeloid leukemia (AML). However, there are no direct comparisons between DAV and 3 + 7 daunorubicin and cytarabine chemotherapy (DA) alone. We performed a propensity score-matched analysis to compare the outcomes of DAV group with historical DA group and identify the clinical and molecular characteristics of patients who might benefit from the DAV regimen. The DAV group had a higher Complete remission (CR) rate than the DA group (90% vs. 55%, p = 0.008). 25 (96%) patients in the DAV group had a higher MRD-negative CRc rate compared with 13 (62%) patients in the DA group (p = 0.006). After a median follow-up duration of 19.15 (IQR 17.13-21.67) months, the DAV group had an improved overall survival (p = 0.001) and event-free survival (p = 0.069), but not disease-free survival (p = 0.136). Collectively, DAV regimen induced high CR rates and deep MRD-negative CRc rates after one cycle of induction therapy, as well as prolonged the overall survival, in young adult patients with AML who were eligible for intensive chemotherapy. The addition of venetoclax to intensive chemotherapy should be considered in the future to achieve better survival advantages in eligible AML patients.
维奈克拉联合 3+7 柔红霉素和阿糖胞苷化疗(DAV)在适合的初诊急性髓系白血病(AML)患者中显示出安全性和有效性。然而,DAV 与单独 3+7 柔红霉素和阿糖胞苷化疗(DA)之间尚无直接比较。我们进行了倾向评分匹配分析,以比较 DAV 组与历史 DA 组的结果,并确定可能从 DAV 方案中获益的患者的临床和分子特征。与 DA 组(55%)相比,DAV 组的完全缓解(CR)率更高(90%,p=0.008)。与 DA 组(62%)相比,DAV 组中有 25 名(96%)患者达到了更高的微小残留病阴性 CRc 率(p=0.006)。在中位数随访 19.15 个月(IQR 17.13-21.67)后,DAV 组的总生存(p=0.001)和无事件生存(p=0.069)得到改善,但无病生存(p=0.136)无差异。总之,在适合强化化疗的年轻 AML 患者中,DAV 方案在诱导治疗一个周期后可诱导高 CR 率和深度微小残留病阴性 CRc 率,并延长总生存。在适合的 AML 患者中,应考虑将维奈克拉加入强化化疗以获得更好的生存优势。