Treating Relapsed AML With Venetoclax, Azacitidine, and Donor Lymphocyte Infusion
Posted: Tuesday, November 23, 2021
Venetoclax plus azacitidine and donor lymphocyte infusion (DLI) may prove to be an effective treatment option for patients with relapsed acute myeloid leukemia (AML) after allogeneic hematopoietic stem cell transplantation (allo-HSCT), according to Jishi Wang, PhD, of Guiyang Medical College, China, and colleagues. The study, which was published in Annals of Hematology, additionally used whole-exome sequencing of bone marrow samples to analyze common mutations in these patients.
“Relapsed disease has always been a predominant challenge in AML treatment, and most of the relapsed patients are at an older age, which obviously enhances the difficulty of management,” the study authors remarked. “The three treatments in our study…are reported to be tolerable in relapsed AML patients, both in combination with other therapies or alone.”
The study enrolled 26 individuals with relapsed AML after allo-HSCT. All were patients in the Hematopoietic Stem Cell Transplantation Center of Guizhou Province; they were between the ages of 16 and 60 and had a life expectancy greater than 4 weeks. For gene-mutation analysis, sequencing data were compared with two public AML gene mutation data sets (TCGA-LAML and AACR project GENIE) using National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology.
The results showed an objective remission rate of 61.5%, and the rates of complete remission with incomplete recovery and partial recovery were 26.9%, and 34.6%, respectively. The median event-free survival was 120 days (95% confidence interval [CI] = 71–610 days), and the median overall survival was 284.5 days (95% CI = 81–610 days). Gene-mutation analysis revealed that many common prognostic mutations, such as FLT3, CEBPA, and DNMT3A, were not correlated with event-free or overall survival.
Common adverse events included agranulocytosis, anemia, and thrombocytopenia. However, according to the investigators, no serious events were reported.
Disclosure: The study authors reported no conflicts of interest.