Salvage use of venetoclax-based therapy for relapsed AML post allogeneic hematopoietic cell transplantation

Joshi, Maansi; Cook, Joselle; McCullough, Kristen; Nanaa, Ahmad; Gangat, Naseema; Foran, James M.; Murthy, Hemant S.; Kharfan‐Dabaja, Mohamed A.; Sproat, Lisa; Palmer, Jeanne; Pardanani, Animesh; Tefferi, Ayalew; Begna, Kebede H.; Elliot, Michelle; Al‐Kali, Aref; Patnaik, Mrinal M.; Shah, Mithun Vinod; Litzow, Mark R.; Alkhateeb, Hassan B.

doi:10.1038/s41408-021-00437-z

Cited by 32 publications

(28 citation statements)

References 14 publications

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“…This review showed that most patients were treated with VEN + HMA as a salvage approach previous to an HSCT; however, we found several studies that included previously transplanted patients. Focusing on those studies, we observed response rates of 36%, 22 38% 33 and 42.1% 25 and mOS of up to 11 months. 22 Although the results in this group of patients may be discrete compared with those obtained in patients who have not previously received an HSCT, this scheme may be an option for patients with few therapeutic alternatives.…”

Section: Discussionmentioning

confidence: 73%

“…VEN + HMA regimen has been used in naïve 15 and R/R patients, 17 – 31 , 33 being a therapeutic alternative in patients who are not candidates for HSCT. This review showed that most patients were treated with VEN + HMA as a salvage approach previous to an HSCT; however, we found several studies that included previously transplanted patients.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of adverse reactions reported for VEN combination therapy was higher than that reported for HMA monotherapy. 15 VEN + HMA regimen has been used in naïve 15 and R/R patients, [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]33 being a therapeutic alternative in patients who are not candidates for HSCT. This review showed that most patients were treated with VEN + HMA as a salvage approach previous to an HSCT; however, we found several studies that included previously transplanted patients.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 16 observational studies of VEN + HMA combination therapy for R/R AML patients were identified (15 retrospective and 1 prospective) and 1 phase 1 clinical trial. 17 – 33 Of them, 16 included adults, 17 – 31 , 33 the majority being elderly patients, and only one study focused on paediatric patients and young adults. 32 …”

Section: Ven Combination Therapy In R/r Aml Patientsmentioning

confidence: 99%

“…A total of 16 observational studies of VEN + HMA combination therapy for R/R AML patients were identified (15 retrospective and 1 prospective) and 1 phase 1 clinical trial. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Of them, 16 included adults, [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]33 the majority being elderly patients, and only one study focused on paediatric patients and young adults. 32 Five hundred sixty-four patients were treated in 17 studies, 177 (31.38%) patients received VEN + AZA and 320 (56.73%) received VEN + DEC.…”

Section: Ven Combination Therapy In R/r Aml Patientsmentioning

confidence: 99%

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Venetoclax combination therapy with hypomethylating agents in young adults with relapsed/refractory acute myeloid leukaemia

Gutiérrez

Ramallo

Moreno

et al. 2021

Therapeutic Advances in Hematology

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In recent years, one of the most successful advances in treating acute myeloid leukaemia (AML) has been the combination of the B-cell lymphoma 2 (BCL-2) inhibitor venetoclax with hypomethylating agents (decitabine or azacytidine). This combination treatment has an accelerated approval by the Food and Drug Administration for newly diagnosed AML adults who are 75 years of age or older or who have comorbidities and are not eligible to receive intensive induction chemotherapy. AML is the most common form of acute leukaemia in adults, with a median age at diagnosis of 68 years. Consequently, most of the patients included in the studies are elderly. Traditionally, young patients achieve higher remission rates compared with the elderly AML population. Although venetoclax combination therapy could become a treatment option for treating young patients with relapsed/refractory AML, this regimen has not been systematically tested in this setting. In this study, we summarize the currently available evidence on the treatment of venetoclax in combination with hypomethylating agents for the treatment of young relapsed/refractory AML patients, in addition to our experience in clinical practice with two case reports. Venetoclax, combined with hypomethylating agents, seems to be an effective option for young relapsed/refractory AML patients. However, due to the poor quality of the evidence, additional well-designed studies with greater numbers of patients are needed to confirm the effectiveness and safety of venetoclax combination regimens for this population.

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