Comparison of the efficacy of continuous VA chemotherapy and I/HDAC consolidation in postremission therapy for acute myeloid leukemia fit for standard chemotherapy
10.3760/cma.j.cn121090-20240529-00198
- VernacularTitle:缓解后FIT状态急性髓系白血病接受持续VA与中大剂量阿糖胞苷巩固治疗疗效比较
- Author:
Li SUN
1
;
Pengpeng ZHANG
;
Simei REN
;
Nan ZHOU
;
Liyuan LI
;
Zhenzhen WANG
;
Weiguang CUI
;
Fan YANG
;
Jianmin LUO
;
Lin YANG
Author Information
1. 河北医科大学第二医院血液科，河北省血液病学重点实验室，石家庄 050000
- Publication Type:Journal Article
- Keywords:
Leukemia, myeloid, acute;
Aged;
Venetoclax;
Cytarabine;
Post-remission treatment
- From:
Chinese Journal of Hematology
2025;46(4):343-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy and safety of continuous venetoclax combined azacitidine (VA) chemotherapy and intermedium/high-dose cytarabine (I/HDAC) consolidation in patients with acute myeloid leukemia (AML) fit for standard chemotherapy (transform from UNFIT) .Methods:Clinical data of patients who were fit for standard chemotherapy were collected among those with AML who underwent VA induction in the Department of Hematology, the Second Hospital of Hebei Medical University. The overall survival (OS), relapse-free survival (RFS), event-free survival (EFS), and incidence of adverse events were analyzed retrospectively.Results:This study enrolled 69 patients, consisting of 46 cases in the VA group and 23 cases in the I/HDAC group. We revealed the following. ① The median OS, RFS, EFS were 26.18, 24.69, 20.34 months in the VA group, and 34.14, 30.99, 28.42 months in the I/HDAC group, respectively, with no statistically significant difference (all P>0.05). Median OS of patients who underwent I/HDAC consolidation with European Leukemia Net (ELN) favorable-risk, positive measurable residual disease (MRD), wild type FLT3, or IDH1/2 mutation was significantly longer than those who received VA ( P<0.05). ②Adverse events rate of grade 3 - 4 neutropenia, grade 3 - 4 thrombocytopenia, and bacteremia were significantly lower in the VA group than in the I/HDAC group ( P<0.05) . Conclusions:I/HDAC consolidation was more likely to help get survival benefits for patients with ELN favorable-risk, positive MRD, wild type FLT3, or IDH1/2 mutation. Continuous VA chemotherapy exhibited superior safety than I/HDAC consolidation.
