Rong Chunmeng, Yang Fang, Chen Yalu, Wang Ming, Ai Cheng, Luo Yuqing, Gao Panpan, Weng Yiqin, Huang Xiaguang, Gu Meier, Huang Weiping, Xia Yongming
Department of Hematopathology, Yuyao People's Hospital, Yuyao, Zhejiang 315400, P.R. China.
Clinical Laboratory Department, Yuyao People's Hospital, Yuyao, Zhejiang 315400, P.R. China.
Oncol Lett. 2024 Mar 26;27(5):228. doi: 10.3892/ol.2024.14362. eCollection 2024 May.
In the present study, the aim was to evaluate the clinical efficacy and safety of low-dose venetoclax combined with azacitidine for the treatment of older and frail patients with newly diagnosed acute myeloid leukaemia (AML). Data of 26 older patients with newly diagnosed AML admitted to Yuyao People's Hospital (Yuyao, China) between January 2021 and May 2023 were retrospectively analysed. The treatment regimens were as follows: Subcutaneous injection of 100 mg azacitidine on days 1-5 and 100 mg oral venetoclax on days 3-16 or 200 mg oral venetoclax on days 3-30. The median age of the 26 patients was 73 years. After the first course of treatment, the complete remission (CR) and CR with incomplete haematological recovery rate was 84.6%, and the objective response rate was 96.2%. The most common adverse events noted during treatment were haematological adverse events including grade 3/4 granulocytosis (57.7%), febrile neutropenia (30.8%), pulmonary infection (32.0%), thrombocytopenia (42.3%) and anaemia (42.3%). A total of 13 (50.0%) patients did not require platelet (PLT) infusion during treatment. The main non-haematological adverse reactions included gastrointestinal reactions such as nausea, vomiting and diarrhoea. Patients were followed up until December 2023, with a median follow-up time of 9.5 months (range, 1.9-26.0 months). Of the 26 patients, nine (34.6%) patients experienced relapse, with a mean recurrence time of 5.9 months. In conclusion, preliminary results indicated that low-dose venetoclax combined with azacitidine is effective and safe for the treatment of older and frail patients with newly diagnosed AML, providing a new treatment option for these patients.
在本研究中，目的是评估低剂量维奈克拉联合阿扎胞苷治疗新诊断的老年体弱急性髓系白血病（AML）患者的临床疗效和安全性。回顾性分析了2021年1月至2023年5月期间余姚市人民医院（中国余姚）收治的26例新诊断AML老年患者的数据。治疗方案如下：第1 - 5天皮下注射100mg阿扎胞苷，第3 - 16天口服100mg维奈克拉或第3 - 30天口服200mg维奈克拉。26例患者的中位年龄为73岁。第一个疗程治疗后，完全缓解（CR）和伴有不完全血液学恢复的CR率为84.6%，客观缓解率为96.2%。治疗期间最常见的不良事件是血液学不良事件，包括3/4级粒细胞增多（57.7%）、发热性中性粒细胞减少（30.8%）、肺部感染（32.0%）、血小板减少（42.3%）和贫血（42.3%）。共有13例（50.0%）患者在治疗期间不需要输注血小板（PLT）。主要的非血液学不良反应包括胃肠道反应，如恶心、呕吐和腹泻。对患者随访至2023年12月，中位随访时间为9.5个月（范围1.9 - 26.0个月）。26例患者中，9例（34.6%）患者复发，平均复发时间为5.9个月。总之，初步结果表明低剂量维奈克拉联合阿扎胞苷治疗新诊断的老年体弱AML患者有效且安全，为这些患者提供了一种新的治疗选择。
