Outcomes of relapsed or refractory acute myeloid leukemia patients failing venetoclax-based salvage therapies.
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Bridged Bicyclo Compounds, Heterocyclic
/ administration & dosage
Drug Resistance, Neoplasm
Female
Humans
Leukemia, Myeloid, Acute
/ drug therapy
Male
Middle Aged
Neoplasm Staging
Prognosis
Recurrence
Salvage Therapy
Sulfonamides
/ administration & dosage
Treatment Failure
Young Adult
acute myeloid leukemia
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
17
07
2020
revised:
23
09
2020
accepted:
24
09
2020
pubmed:
1
10
2020
medline:
29
7
2021
entrez:
30
9
2020
Statut:
ppublish
Résumé
We conducted a retrospective analysis to evaluate the outcomes of 28 heavily pretreated (median 3 (2-6) treatment lines, sixteen (57%) allotransplanted) relapsed/refractory acute myeloid leukemia patients who had failed salvage venetoclax-based therapies. The median age was 59 years (20-80), 20 patients (71%) had ECOG 2-4 status, and 18 patients (64%) were stratified to European Leukemia Network 2017 adverse risk group. The most common mutations were ASXL1 (21%), RUNX1 (18%), FLT3 ITD/TKD (18%), PTPN11 (15%), NRAS/KRAS (15%), and WT1 (15%). Twenty-two patients (79%) received different post-venetoclax salvage therapies with the overall response rate of 23% (complete remission + morphological leukemia-free state). Three of six (50%) patients achieved complete remissions after therapy with venetoclax + actinomycin D ± low-dose cytarabine. The remaining 6 patients did not receive any further salvage treatment mainly due to poor general condition. The median overall survival was 3.9 months for all patients (4.3 for those receiving post-venetoclax salvage vs 1.3 months receiving palliative care alone, P < .001). Though the remission rate and survival of patients failing venetoclax are poor, a small proportion of these R/R AML patients may still respond to cautious intensification of chemotherapy with venetoclax.
Substances chimiques
Bridged Bicyclo Compounds, Heterocyclic
0
Sulfonamides
0
venetoclax
N54AIC43PW
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105-113Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
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