Efficacy and safety of modified VIALE-A regimen for treatment of elderly patients with intermediate or high risk myelodysplastic syndromes
10.3760/cma.j.cn115356-20240110-00008
- VernacularTitle:VIALE-A改良方案治疗高龄中高危骨髓增生异常综合征患者效果与安全性
- Author:
Qixin SUN
1
;
Zhenzhen WEN
;
Xiaoyan CHEN
;
Ahui WANG
;
Guiping CHEN
;
Ziyuan ZHAO
;
Zhigang ZHU
Author Information
1. 广州市第一人民医院老年血液肿瘤科，广州 510180
- Keywords:
Myelodysplastic syndromes;
Venetoclax;
Azacytidine;
Treatment outcome;
Adverse reactions
- From:
Journal of Leukemia & Lymphoma
2024;33(8):462-465
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of the modified VIALE-A regimen in the treatment of elderly (>75 years old) patients with intermediate or high risk myelodysplastic syndromes (MDS).Methods:A retrospective case series analysis was conducted. Clinical data were collected from 7 MDS patients aged >75 years who were continuously treated with the modified VIALE-A regimen (azacytidine 75 mg/m 2 per day from day 1 to day 7 + venetoclax 200 mg per day from day 8 to day 28) from May 2021 to August 2023, and the patients were diagnosed according to the World Health Organization 2016 staging criteria and were determined to be at intermediate or high risk according to the revised International Prognostic Scoring System. The patients' efficacy and common adverse reactions were analyzed, and the Kaplan-Meier method was used for survival analysis. Results:Of the 7 patients, 5 were female and 2 were male; the median age [ M ( Q1, Q3)] was 84 years old (80 years old, 90 years old). One patient failed the initial treatment, and the remaining 6 achieved complete remission or complete remission in bone marrow after induction therapy with the modified VIALE-A regimen in 1-2 courses. By the follow-up cut-off date of December 31st, 2023, the median follow-up was 10 months (5 months, 18 months) and the median overall survival time was 18 months (95% CI: 0-39 months). Grade 3-4 myelosuppression occurred in all 7 patients during the induction phase, with granulocytopenia lasting 7-10 d; Of the 64 courses of maintenance treatment, 54 (84%) had grade 1-3 myelosuppression; non-hematologic adverse reactions were mild; no treatment interruptions occurred in the cumulative 73 courses. Conclusions:The modified VIALE-A regimen is moderately efficacious in elderly patients with intermediate or high risk MDS, with controllable adverse reactions.
