Chen Tzu-Ting, Lin Ching-Chan, Lo Wen-Jyi, Hsieh Ching-Yun, Lein Ming-Yu, Lin Che-Hung, Lin Chen-Yuan, Bai Li-Yuan, Chiu Chang-Fang, Yeh Su-Peng
Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan.
Division of Hematology and Oncology, Department of Internal Medicine, An Nan Hospital, Tainan 700, Taiwan.
Cancers (Basel). 2024 Mar 7;16(6):1082. doi: 10.3390/cancers16061082.
Allogeneic hematopoietic stem cell transplantation (HSCT) is rarely recommended for unfit patients with newly diagnosed acute myeloid leukemia (AML). Patient survival can improve with venetoclax plus azacitidine (VEN plus AZA). However, the long-term outcome of this treatment strategy is still unsatisfactory. The high response and low treatment toxicity rates of patients receiving VEN plus AZA can provide an opportunity for HSCT among unfit patients. Nevertheless, the outcomes and complications of VEN plus AZA, followed by HSCT, remain unclear.
This single-center retrospective study aimed to compare patients with newly diagnosed AML receiving VEN plus AZA as induction therapy ( = 27) to those receiving the conventional I3A7 regimen as induction therapy ( = 34).
The 1-year overall survival, relapse, and non-relapse mortality rates in the two groups were similar. The cytogenetic risks and the hematopoietic cell transplantation-specific comorbidity index are the most significant predictive factors of overall survival.
In older patients unfit for intensive chemotherapy, a low-intensity regimen with VEN plus AZA is a suitable bridge therapy. Furthermore, allo-HSCT is feasible and can be a curative option.
对于新诊断的急性髓系白血病（AML）不适合进行强化疗的患者，很少推荐进行异基因造血干细胞移植（HSCT）。维奈克拉联合阿扎胞苷（VEN联合AZA）可提高患者生存率。然而，这种治疗策略的长期疗效仍不尽人意。接受VEN联合AZA治疗的患者缓解率高且治疗毒性低，这为不适合进行HSCT的患者提供了进行HSCT的机会。尽管如此，VEN联合AZA后序贯HSCT的疗效和并发症仍不明确。
本单中心回顾性研究旨在比较新诊断的AML患者接受VEN联合AZA作为诱导治疗（n = 27）与接受传统I3A7方案作为诱导治疗（n = 34）的情况。
两组的1年总生存率、复发率和非复发死亡率相似。细胞遗传学风险和造血细胞移植特异性合并症指数是总生存的最显著预测因素。
对于不适合进行强化疗的老年患者，VEN联合AZA的低强度方案是合适的桥接治疗。此外，异基因HSCT是可行的，并且可以作为一种治愈性选择。
