Venetoclax plus a hypomethylating agent versus cytarabine, aclarubicin, and granulocyte colony-stimulating factor chemotherapy as a first-line therapy for newly diagnosed acute myeloid leukemia: A propensity score-matched analysis.
Cancer
; 130(14): 2472-2481, 2024 Jul 15.
Article
in En
| MEDLINE
| ID: mdl-38470375
ABSTRACT
BACKGROUND:
Both venetoclax plus a hypomethylating agent (VEN/HMA) and cytarabine, aclarubicin, and granulocyte colony-stimulating factor (CAG) are low-intensity regimens for older patients with acute myeloid leukemia (AML) that show good efficacy and safety. It is unknown how VEN/HMA compares with the CAG regimen for the treatment of newly diagnosed AML.METHODS:
The outcomes of patients with newly diagnosed AML treated with VEN/HMA were compared with those of patients treated with a CAG-based regimen. Propensity score matching between these two cohorts at a 11 ratio was performed according to age at diagnosis, sex, Eastern Cooperative Oncology Group performance status, state of fitness, and European LeukemiaNet (ELN) 2022 risk stratification to minimize bias.RESULTS:
A total of 84 of 96 patients in the VEN/HMA cohort were matched with 84 of 147 patients in the CAG cohort. VEN/HMA resulted in a better response than the CAG-based regimens, as indicated by a higher composite complete remission (CRc) rate (82.1% vs. 60.7%; p = .002) and minimal residual disease negativity rate (88.2% vs. 68.2%; p = .009). In patients with an ELN adverse risk, VEN/HMA was associated with a higher CRc rate compared to CAG (80.5% vs. 58.3%; p = .006). VEN/HMA was associated with longer event-free survival (EFS) (median EFS, not reached vs. 4.5 months; p = .0004), whereas overall survival (OS) was comparable between the two cohorts (median OS, not reached vs. 18 months; p = .078).CONCLUSIONS:
The VEN/HMA regimen may result in a better response than CAG-based treatment in older patients with newly diagnosed AML.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Sulfonamides
/
Aclarubicin
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Leukemia, Myeloid, Acute
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Antineoplastic Combined Chemotherapy Protocols
/
Granulocyte Colony-Stimulating Factor
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Bridged Bicyclo Compounds, Heterocyclic
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Cytarabine
/
Propensity Score
Limits:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2024
Type:
Article