Venetoclax‐based therapy for relapsed or refractory acute myeloid leukaemia following intensive induction chemotherapy

Abstract

BackgroundThe treatment of relapsed or refractory (R/R) acute myeloid leukaemia (AML) remains challenging and outcomes extremely poor. The introduction of venetoclax has transformed the treatment of AML and emerging data suggest that venetoclax‐based therapy may enforce salvage treatment.Materials and MethodsIn this nationwide Danish retrospective study, we analysed treatment outcomes of venetoclax‐based salvage treatment for R/R AML between 2019 and 2022. Only venetoclax‐naive patients who had previously received treatment with intensive chemotherapy therapy were included.ResultsThe cohort consisted of 43 R/R patients with a median age of 57 years. Nine (20.9%) were primary refractory and 34 (79.1%) patients had relapsed, including 21 after previous allogeneic stem cell transplantation. The overall response rate was 76.2% including 61.9% with composite complete remission (CRc: CR + CRi). Among CRc‐responders with information on measurable residual disease (MRD), 8/13 (61.5%) obtained an MRD‐negativity response. The overall survival was 9.3 months for all patients with an estimated 1‐year overall survival of 34%. For CRc‐responders the median overall survival was 13.3 months, and the median relapse‐free survival was 12.8 months.ConclusionVenetoclax‐based salvage treatment for R/R AML produced high response rates; however, for most patients the response was of limited duration. This study is limited by an observational design and prone to selection bias.

AML in the elderly—A global view

“…At the GP and subsequently at the secondary centre, blood sampling has shown leukocytosis of 35 The perspective from China (J Jin) I serve as the Director of the Department of Hematology at the First Affiliated Hospital of Zhejiang University School of Medicine, China. Additionally, I hold the position of Director at the Key Laboratory of Hematological Malignancy in Zhejiang Province, China.…”

“…If the patient received 7 + 3 as induction, 14 relapse therapy could be VEN/AZA. 35 However, if this is a fit patient with adverse genetic risk, the combination of venetoclax, lowdose cytarabine and cladribine, alternating with decitabine and venetoclax, is attractive. 36 A more intensive regimen like FLAG-Ida will likely not be used.…”