Venetoclax and donor lymphocyte infusion for early relapsed acute myeloid leukemia after allogeneic hematopoietic cell transplantation. A retrospective multicenter trial.
Adult
Aged
Bridged Bicyclo Compounds, Heterocyclic
/ therapeutic use
Chemotherapy, Adjuvant
Combined Modality Therapy
Female
Graft vs Host Disease
/ mortality
Hematopoietic Stem Cell Transplantation
/ adverse effects
Humans
Leukemia, Myeloid, Acute
/ mortality
Lymphocyte Transfusion
Male
Middle Aged
Neoplasm Recurrence, Local
/ mortality
Postoperative Period
Recurrence
Retrospective Studies
Salvage Therapy
/ methods
Sulfonamides
/ therapeutic use
Survival Analysis
Time Factors
Transplantation, Homologous
/ adverse effects
AML
Allogeneic HCT
DLI
Relapse
Venetoclax
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
18
10
2020
accepted:
03
01
2021
pubmed:
15
1
2021
medline:
6
3
2021
entrez:
14
1
2021
Statut:
ppublish
Résumé
Prognosis in patients with post allogeneic HCT-early relapse of acute myeloid leukemia (<6 months post HCT) is dismal and response to salvage treatment is < 20%. In addition, majority of patients at this early point are unable to withstand intensive salvage chemotherapy. We hypothesized that the combination of donor lymphocyte infusion (DLI) and venetoclax may result in increased response in this difficult to treat patient group. We retrospectively analyzed 22 patients from February 2017-December 2019, who were given the Venetoclax/DLI combination. Median age was 65 (43-75) years. There were no cases of tumor lysis syndrome. Microbiology documented infections occurred in 8 patients (36%). Majority were able to tolerate the protocol without admissions. Acute GVHD was observed in 4 (18%) patients and cGVHD was observed in 6 (27%) patients. Overall response was observed in 11 (50%) patients (CR, n = 4; CRi, n = 1; CRp, n = 4; MLFS n = 2). Median time to response was 28 (18-67) days and median cycles of venetoclax 2 [1-8] and duration of response were 135 (31-564) days. Median survival was 6.1 months (95% CI .73-11.4). Cox regression model for survival showed decreased WBC at relapse, GVHD and better performance status were associated with better survival. These results may endorse the hypothesis that enhancing alloreactivity combined with venetoclax is safe and efficacious and should be further investigated in prospective trials.
Identifiants
pubmed: 33442793
doi: 10.1007/s00277-021-04398-y
pii: 10.1007/s00277-021-04398-y
doi:
Substances chimiques
Bridged Bicyclo Compounds, Heterocyclic
0
Sulfonamides
0
venetoclax
N54AIC43PW
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
817-824Références
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