Department of Hematology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, People's Republic of China.
Hematology. 2024 Dec;29(1):2350319. doi: 10.1080/16078454.2024.2350319. Epub 2024 May 15.
The purpose of this study was to compare the effectiveness of the combination of venetoclax and hypomethylating agents with the HAG regimen.
We studied 52 cases of newly diagnosed AML and 26 cases of relapsed refractory AML, (including AML patients with treatment-related and ELN-adverse risk disease (n = 50)). These patients were treated with venetoclax and hypomethylating agents and HAG regimens, respectively.
Twenty-nine patients newly diagnosed with acute myeloid leukemia were treated with VEN-HMA (venetoclax-hypomethylating agent), while 23 patients were treated with HAG. The median age of the VEN-HMA group was 70 years, while the HAG group had a median age of 69 years. The VEN-HMA group achieved a significantly higher rate of complete remission (82.7%) compared to the cohort treated with the HAG regimen (21.7%) (< 0.001). At the same time, the VEN-HMA group exhibited a significant survival advantage compared to the HAG treatment group(HR = 0.328, 95%CI: 0.158-0.683, = 0.003).In patients with relapsed and refractory acute myeloid leukaemia, 43.8% of patients in the VEN-HMA treatment group achieved complete remission, which was similar to the 50% in the HAG treatment group (> 0.99). The median overall survival was similar between the VEN-HMA and HAG groups, with 4 and 3.67 months, respectively (= 0.290).
In conclusion, our analyses indicated that VEN-HMA resulted in better therapeutic outcomes compared to HAG for newly diagnosed AML patients, with higher rates of complete remission and overall survival. In relapsed/refractory AML patients, there was no significant difference in the efficacy of the two treatments and further studies with larger sample sizes are warranted.
本研究旨在比较 venetoclax 联合低甲基化药物与 HAG 方案的疗效。
我们研究了 52 例初诊 AML 患者和 26 例复发难治性 AML 患者(包括 50 例治疗相关和 ELN 不良风险疾病的 AML 患者)。这些患者分别接受 venetoclax 联合低甲基化药物和 HAG 方案治疗。
29 例初诊急性髓系白血病患者接受 VEN-HMA(venetoclax-低甲基化药物)治疗,23 例患者接受 HAG 治疗。VEN-HMA 组的中位年龄为 70 岁,HAG 组的中位年龄为 69 岁。VEN-HMA 组完全缓解率(82.7%)明显高于 HAG 组(21.7%)(<0.001)。同时,VEN-HMA 组与 HAG 治疗组相比具有显著的生存优势(HR=0.328,95%CI:0.158-0.683,=0.003)。在复发/难治性急性髓系白血病患者中,VEN-HMA 治疗组有 43.8%的患者达到完全缓解,与 HAG 治疗组的 50%相似(>0.99)。VEN-HMA 组和 HAG 组的中位总生存期相似,分别为 4 个月和 3.67 个月(=0.290)。
总之,我们的分析表明,VEN-HMA 方案在初诊 AML 患者中的疗效优于 HAG 方案,完全缓解率和总生存率更高。在复发/难治性 AML 患者中,两种治疗方法的疗效无显著差异,需要进一步开展更大样本量的研究。