Mims Alice, Xie Zhuoer, Potluri Ravi, Rotter David, Chevli Manoj, Prebet Thomas, Gaugler Lona, Strocchia Maria, Vasconcelos Alberto, Sieluk Jan
Ohio State University, Columbus, OH, USA.
Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA.
Leuk Lymphoma. 2025 Mar;66(3):479-487. doi: 10.1080/10428194.2024.2425792. Epub 2024 Nov 28.
Oral azacitidine (Oral-AZA) is recommended as maintenance therapy for patients with newly diagnosed acute myeloid leukemia (ND AML) achieving remission with intensive chemotherapy (IC) but not transplant candidates; venetoclax plus injectable azacitidine (VEN-AZA) is recommended for patients ineligible for IC. Some patients may be considered candidates for either regimen. This retrospective study used Flatiron Health's database to compare treatment patterns and clinical outcomes with Oral-AZA maintenance after IC (IC🡪Oral-AZA) versus frontline VEN-AZA. Relapse-free survival (RFS) and overall survival (OS) were analyzed at 4 different time points, including from Oral-AZA initiation (IC🡪Oral-AZA cohort) or from remission (VEN-AZA cohort) in the Core Analysis. Median RFS was 14.9 and 8.1 months for IC🡪Oral-AZA and VEN-AZA propensity score-matched cohorts, in the Core Analysis ( = 32 in each; = 0.027); median OS was 18.7 and 15.2 months ( = 0.034). In patients with AML, IC🡪Oral-AZA significantly improved RFS and OS compared with VEN-AZA.
口服阿扎胞苷（Oral-AZA）被推荐作为新诊断的急性髓系白血病（ND AML）患者强化化疗（IC）达到缓解但不适合移植时的维持治疗；维奈克拉联合注射用阿扎胞苷（VEN-AZA）被推荐用于不适合IC的患者。一些患者可能被认为适用于这两种治疗方案中的任何一种。这项回顾性研究使用了Flatiron Health数据库，比较IC后口服阿扎胞苷维持治疗（IC🡪Oral-AZA）与一线VEN-AZA的治疗模式和临床结局。在4个不同时间点分析无复发生存期（RFS）和总生存期（OS），包括核心分析中从口服阿扎胞苷开始（IC🡪Oral-AZA队列）或从缓解时开始（VEN-AZA队列）。在核心分析中，IC🡪Oral-AZA和VEN-AZA倾向评分匹配队列的中位RFS分别为14.9个月和8.1个月（每组n = 32；P = 0.027）；中位OS分别为18.7个月和15.2个月（P = 0.034）。在急性髓系白血病患者中，与VEN-AZA相比，IC🡪Oral-AZA显著改善了RFS和OS。
