A Real-life Turkish Experience of Venetoclax Treatment in High-risk Myelodysplastic Syndrome and Acute Myeloid Leukemia

Gemici, Ali; Özkalemkaş, Fahir; Doğu, Mehmet Hilmi; Tekinalp, Atakan; Alacacıoğlu, İnci; Guney, Tekin; İnce, İdris; Gedük, Ayfer; Çağlıyan, Gülsüm Akgün; Maral, Senem; Serin, İstemi; Gündüz, Eren; Karakuş, Volkan; Beköz, Hüseyin Saffet; Eren, Rafet; Pınar, İbrahim Ethem; Güneş, Ahmet Kürşad; Sargin, Fatma Deniz; Sevindik, Omur Gokmen

doi:10.1016/j.clml.2021.04.004

Cited by 6 publications

(4 citation statements)

References 17 publications

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Section: Discussionmentioning

confidence: 99%

“…Venetoclax (Ven) is a selective BCL2 inhibitor approved in 2018 by Food and Drug Administration (FDA) for use in elderly or ineligible patients with newly diagnosed AML. Ven combined with HMAs (Ven + HMAs) has been gradually adopted in relapsed/refractory AML (R/R -AML) and MDS and showed favorable results [14][15][16][17].Notably, a minority of the included relapsed patients were post-transplant relapses, and these clinical studies initially demonstrated the e cacy of the regimen for managing post-transplant relapses. In recent years, Ven + HMAs therapy for treating post-transplant relapse in AML/MDS has been gradually reported.Considering the use of Ven + HMAs in post-transplant relapse with AML/MDS has been reported on a small scale in recent years, its e cacy and safety are yet to be evaluated.…”

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confidence: 99%

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Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post-transplantation: a systematic review and meta-analysis

Zhang

et al. 2023

Preprint

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Background Currently, there is no standard treatment for managing relapse after allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia and myelodysplastic syndrome (AML/MDS). Venetoclax (Ven)-based therapies have been increasingly used for treating post-transplant relapse. The aim of this systematic review and meta-analysis was to evaluate the efficacy and adverse events of Ven combined with hypomethylating agents (HMAs) for AML/MDS relapse post-transplantation. Methods We searched PubMed, Web of Science, Excerpta Medica Database, Cochrane Library, and Clinical. gov for eligible studies from the inception to February 2022. The Methodological Index for Non-Randomized Studies was used to evaluate the quality of the included literature. The inverse variance method calculated the pooled proportion and 95% confidence interval (CI). Results This meta-analysis included 9 studies involving a total of 202 patients. The pooled complete response and complete response with incomplete blood count recovery rate of Ven combined with HMAs for post-transplant relapse in AML/MDS was 32% (95% CI, 25%-40%, I2 = 0%), with an overall response rate of 50% (95% CI, 40%-59%, I2 = 38%). The 6-month survival rate was 43% (95% CI, 28%-59%, I2 = 68%) and the 1-year survival rate was 27% (95% CI, 13%-42%, I2 = 72%). Conclusion This study demonstrated a moderate benefit of Ven in combination with HMAs for AML/MDS patients with relapsed post-transplantation (including those who have received prior HMAs therapy), and may become one of the treatment options in the future. Large-scale prospective studies are needed to confirm this study in future.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post-transplantation: a systematic review and meta-analysis

Zhang

et al. 2023

Preprint

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“…In another study [ 14 ], CR ratios in AML patients treated with venetoclax plus AZA and venetoclax plus DAC were 71% and 74%, respectively. Venetoclax-based treatment results were evaluated in another study containing real-life data from Turkey [ 15 ]. Six (10%) of the 60 patients were diagnosed with high-risk MDS, and the remaining were diagnosed with AML; the best objective response rate was 35% in the entire cohort.…”

Section: Discussionmentioning

confidence: 99%

The Use of Hypomethylating Agents in Hematologic Malignancies: Treatment Preferences and Results

Serin¹,

Doğu

2021

Int. J. Hematol. Oncol.

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Aim: The objective of this article was to compare the efficiency of azacitidine (AZA) and decitabine (DAC) in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not suitable for high-dose chemotherapy. Materials and methods: MDS and AML patients who were treated with hypomethylating agents (HMAs) between January 2005 and 2020 were evaluated retrospectively. Results: No statistically significant difference was found between the patients who received AZA or DAC in AML patients. In MDS group, the rate of patients who achieved remission was statistically significantly higher in patients who received DAC (p = 0,032). Conclusion: The advantage in terms of response for MDS and no survival difference between AZA and DAC for AML and MDS patients will be an important contribution to the literature.

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“…Venetoclax, a selective BCL2 inhibitor which was approved in 2018 by Food and Drug Administration (FDA), is used in elderly or ineligible patients with newly diagnosed AML,. Venetoclax combined with HMAs (Ven-HMAs) has been gradually adopted to show favorable results in relapsed/refractory AML (R/R AML) and MDS [ 14 – 17 ]. Notably, a minority of the enrolled patients were relapsed AML/MDS post-transplantation who presented effectiveness of Ven-HMAs initially demonstrated by these clinical studies Therefore, Ven-HMAs therapy for treating relapse in AML/MDS post-transplantation has been gradually emerged.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis

Du,

Li,

Zhao

et al. 2023

BMC Cancer

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Background Currently, there is no standard treatment for managing relapse in patients with acute myeloid leukemia and myelodysplastic syndrome (AML/MDS) after allogeneic hematopoietic cell transplantation. Venetoclax-based therapies have been increasingly used for treating post-transplantation relapse of AML. The aim of this systematic review and meta-analysis was to evaluate the efficacy and adverse events of Venetoclax combined with hypomethylating agents (HMAs) for AML/MDS relapse post-transplantation. Methods We searched PubMed, Web of Science, Excerpta Medica Database, Cochrane Library, and Clinical. gov for eligible studies from the inception to February 2022. The Methodological Index for Non-Randomized Studies was used to evaluate the quality of the included literatures. The inverse variance method calculated the pooled proportion and 95% confidence interval (CI). Results This meta-analysis included 10 studies involving a total of 243 patients. The pooled complete response and complete response with incomplete blood count recovery rate of Venetoclax combined with HMAs for post-transplantation relapse in AML/MDS was 32% (95% CI, 26-39%, I2 = 0%), with an overall response rate of 48% (95% CI, 39-56%, I2 = 37%). The 6-month survival rate was 42% (95% CI, 29-55%, I2 = 62%) and the 1-year survival rate was 23% (95% CI, 11-38%, I2 = 78%). Conclusion This study demonstrated a moderate benefit of Venetoclax in combination with HMAs for patients with relapsed AML/MDS post-transplantation (including those who have received prior HMAs therapy), and may become one of treatment options in the future. Large-scale prospective studies are needed to confirm the potential benefit from venetoclax combined with HMAs.

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A Real-life Turkish Experience of Venetoclax Treatment in High-risk Myelodysplastic Syndrome and Acute Myeloid Leukemia

Cited by 6 publications

References 17 publications

Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post-transplantation: a systematic review and meta-analysis

Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post-transplantation: a systematic review and meta-analysis

The Use of Hypomethylating Agents in Hematologic Malignancies: Treatment Preferences and Results

Efficacy and safety of venetoclax combined with hypomethylating agents for relapse of acute myeloid leukemia and myelodysplastic syndrome post allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis

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