Clinical Effects of Venetoclax in the Treatment of Acute Myeloid Leukemia in the Elderly
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Keywords

Venetoclax
Elderly
Acute myeloid leukemia
Efficacy

DOI

10.26689/par.v8i3.7206

Submitted : 2024-05-20
Accepted : 2024-06-04
Published : 2024-06-19

Abstract

Objective: To investigate the clinical efficacy of venetoclax in the treatment of elderly acute myeloid leukemia (AML). Methods: 50 cases of elderly AML patients receiving venetoclax for treatment in the hospital from January 2022 to January 2024 were selected, including 38 cases of patients whose primary treatment was not suitable for intensive chemotherapy and 12 cases of relapsed/refractory AML patients, to observe the therapeutic efficacy and safety of venetoclax. Results: Among the 38 patients whose primary treatment was not suitable for intensive chemotherapy, 5 cases were treated with venetoclax monotherapy, 33 cases were treated with venetoclax + azacitidine, and 25 patients (65.79%) achieved complete remission (CR) with incomplete hematologic recovery (CRi) after 28 days of treatment; 10 patients with relapsed/refractory AML were treated with venetoclax + azacitidine, and 2 patients were treated with venetoclax + azacitidine + chemotherapy, and 2 patients achieved optimal therapeutic response after 28 days of treatment and CR/CRi was achieved in 7 patients (58.33%). There were 47 (94.0%) patients with grade 3 or higher granulocytopenia, 46 (92.0%) patients with hemoglobin reduction, and 43 (86.0%) patients with thrombocytopenia, developed after 28 days of treatment. 11 patients developed infections after treatment and there was one case of tumor lysis syndrome. Conclusion: The response rate of venetoclax monotherapy and combination in elderly AML induction therapy is high, and the overall tolerability of elderly patients is good, so it can be popularized and applied.

References

Kong FC, Qi L, Huang WF, et al., 2023, Efficacy and Survival Analysis of a Vinpocetine-Based Regimen for Acute Myeloid Leukemia. Chinese Journal of Experimental Hematology, 31(6): 1676–1683.

Feng J, Yuan R, Tang H, et al., 2023, Analysis on the Efficacy and Safety of Venetoclax in the Treatment of Acute Myeloid Leukemia. Chinese Journal of Experimental Hematology, 31(4): 960–966.

Huang B, Zhao W, Wang Z, et al., 2024, Efficacy of Venetoclax Combined with Chemotherapy for High-Risk Acute Myeloid Leukemia in Genetics and the Effect of Differential Expression of Anti-Apoptotic Family Proteins. Chinese Journal of Oncology, 46(2): 161–167.

Gao WJ, Yang JJ, Li M, et al., 2024, Prospective Clinical Study of Venetoclax Combined with CACAG Regimen for Refractory/Relapsed Acute Myeloid Leukemia. Chinese Journal of Experimental Hematology, 32(1): 90–95.

Zhao X, Mo X, Zhao J, et al., 2023, Venetoclax for the Treatment of Newly Diagnosed Acute Myeloid Leukemia Unsuitable for Strong Induction Chemotherapy: Real-World Use and Healthcare Resource Utilization. China Pharmacoeconomics, 18(5): 29–36.

Zhang B, Ji J, Wu Y, et al., 2022, Clinical Efficacy and Safety Analysis of Azacitidine Combined with Venetoclax in the Treatment of Newly Diagnosed Acute Myeloid Leukemia Intolerant to Conventional Chemotherapy. Journal of Clinical Internal Medicine, 39(9): 632–634.

Liu WH, Wu T, Xue F, et al., 2022, Venetoclax Combined with Azacitidine for the Treatment of Elderly Patients with Relapsed Acute Myeloid Leukemia and Literature Review. International Journal of Blood Transfusion and Hematology, 45(2): 147–152.

Wang H, 2022, Clinical Observation of Decitabine Combined with Reduced FLAG Regimen in the Treatment of High-Risk Acute Myeloid Leukemia in the Elderly. Clinical Medicine, 42(3): 20–22.

Sun L, Ye S, Zhou N, et al., 2022, Analysis of the Efficacy of Venetoclax in Combination with Azacitidine in the Treatment of Newly Diagnosed Acute Myeloid Leukemia Unsuitable for Standard Chemotherapy: Single-Center Data. Chinese Journal of Hematology, 43(10): 826–832.

Zheng Y, Zhang H, Han S, et al., 2023, A Case of Acute Myeloid Leukemia Secondary to Myeloid Sarcoma Treated with Azacitidine Combined with Venetoclax. China Cancer Clinic, 50(10): 538–539.