TY - JOUR
T1 - Venetoclax in combination with FLAG-IDA-based protocol for patients with acute myeloid leukemia
T2 - a real-world analysis
AU - Wolach, Ofir
AU - Frisch, Avraham
AU - Shargian, Liat
AU - Yeshurun, Moshe
AU - Apel, Arie
AU - Vainstein, Vladimir
AU - Moshe, Yakir
AU - Shimony, Shai
AU - Amit, Odelia
AU - Bar-On, Yael
AU - Ofran, Yishai
AU - Raanani, Pia
AU - Nachmias, Boaz
AU - Ram, Ron
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/8
Y1 - 2022/8
N2 - Venetoclax in combination with intensive therapies is explored in both the upfront and relapse/refractory (R/R) setting, and available data suggest that such regimens are effective albeit with added hematological and infectious toxicity. We conducted a multicenter retrospective cohort study of patients with acute myeloid leukemia (AML) treated with venetoclax in combination with FLAG-IDA protocol. Twenty-five patients were included in this analysis (median age 53.4 years). Most patients were treated for R/R AML (n = 24, 96%) with a median of one (range 0–3) previous lines of therapy and 44% of patients (n = 11) having prior allogeneic hematopoietic cell transplantation (HCT). Median follow-up was 10 (range, 4–26) months. Platelet and neutrophil recovery were observed at a median of 31 (95% CI 17.6–38.3) and 23 (95% CI 20–28) days, respectively. The most common adverse events were infectious (blood stream infections, 48% and invasive fungal infections, 32%). Thirty-day mortality was 12%. Composite complete remission (CRc) was 72% for the entire cohort and 91% in patients treated for post-HCT relapse. Incidences of relapse-free and overall survival at 12 months were 67% (95% CI 58–76%) and 50% (95% CI 31–69%), respectively. Real-world data show that the addition of venetoclax to FLAG-IDA protocol is effective in patients with high-risk AML, most notably in the post-HCT relapse setting. Prophylaxis and surveillance for infections are crucial.
AB - Venetoclax in combination with intensive therapies is explored in both the upfront and relapse/refractory (R/R) setting, and available data suggest that such regimens are effective albeit with added hematological and infectious toxicity. We conducted a multicenter retrospective cohort study of patients with acute myeloid leukemia (AML) treated with venetoclax in combination with FLAG-IDA protocol. Twenty-five patients were included in this analysis (median age 53.4 years). Most patients were treated for R/R AML (n = 24, 96%) with a median of one (range 0–3) previous lines of therapy and 44% of patients (n = 11) having prior allogeneic hematopoietic cell transplantation (HCT). Median follow-up was 10 (range, 4–26) months. Platelet and neutrophil recovery were observed at a median of 31 (95% CI 17.6–38.3) and 23 (95% CI 20–28) days, respectively. The most common adverse events were infectious (blood stream infections, 48% and invasive fungal infections, 32%). Thirty-day mortality was 12%. Composite complete remission (CRc) was 72% for the entire cohort and 91% in patients treated for post-HCT relapse. Incidences of relapse-free and overall survival at 12 months were 67% (95% CI 58–76%) and 50% (95% CI 31–69%), respectively. Real-world data show that the addition of venetoclax to FLAG-IDA protocol is effective in patients with high-risk AML, most notably in the post-HCT relapse setting. Prophylaxis and surveillance for infections are crucial.
KW - High-risk AML
KW - Intensive chemotherapy
KW - Salvage
KW - Venetoclax
UR - http://www.scopus.com/inward/record.url?scp=85132352386&partnerID=8YFLogxK
U2 - 10.1007/s00277-022-04883-y
DO - 10.1007/s00277-022-04883-y
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 35732976
AN - SCOPUS:85132352386
SN - 0939-5555
VL - 101
SP - 1719
EP - 1726
JO - Annals of Hematology
JF - Annals of Hematology
IS - 8
ER -