Real-world use of venetoclax in the treatment of paediatric and teenage/young adult haematological malignancies.

acute leukaemia childhood leukaemia clinical studies leukaemia therapy myeloid leukaemia

Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
26 Sep 2024
Historique:
received: 05 08 2024
accepted: 17 09 2024
medline: 27 9 2024
pubmed: 27 9 2024
entrez: 27 9 2024
Statut: aheadofprint

Résumé

Early-phase trials of venetoclax in children and teenagers/young adults with leukaemia have yielded promising results, but there remains a paucity of real-world data. To address this, we report a cohort of 41 children treated with venetoclax for a range of haematological malignancies, demonstrating complete remission in 43.6%, with most achieving minimal residual disease (MRD) negativity. Venetoclax was particularly effective as a bridge to transplant, with bridging successful in 75% of patients. Patients with MRD <1% at initiation of venetoclax were more likely to achieve MRD negativity (81.8% vs. 34.5%, p = 0.007) and had improved overall survival (54.5% vs. 17.9%, p = 0.004).

Identifiants

pubmed: 39327775
doi: 10.1111/bjh.19791
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 British Society for Haematology and John Wiley & Sons Ltd.

Références

Roberts AW, Davids MS, Pagel JM, Kahl BS, Puvvada SD, Gerecitano JF, et al. Targeting BCL2 with venetoclax in relapsed chronic lymphocytic leukemia. N Engl J Med. 2016;374(4):311–322.
DiNardo CD, Jonas BA, Pullarkat V, Thirman MJ, Garcia JS, Wei AH, et al. Azacitidine and venetoclax in previously untreated acute myeloid leukemia. N Engl J Med. 2020;383(7):617–629.
Karol SE, Alexander TB, Budhraja A, Pounds SB, Canavera K, Wang L, et al. Venetoclax in combination with cytarabine with or without idarubicin in children with relapsed or refractory acute myeloid leukaemia: a phase 1, dose‐escalation study. Lancet Oncol. 2020;21(4):551–560.
Trabal A, Gibson A, He J, McCall D, Roth M, Nuñez C, et al. Venetoclax for acute myeloid leukemia in pediatric patients: a Texas medical center experience. Cancers (Basel). 2023;15(7):1983. https://doi.org/10.3390/cancers15071983
Winters AC, Maloney KW, Treece AL, Gore L, Franklin AK. Single‐center pediatric experience with venetoclax and azacitidine as treatment for myelodysplastic syndrome and acute myeloid leukemia. Pediatr Blood Cancer. 2020;67(10):e28398.
Pullarkat VA, Lacayo NJ, Jabbour E, Rubnitz JE, Bajel A, Laetsch TW, et al. Venetoclax and navitoclax in combination with chemotherapy in patients with relapsed or refractory acute lymphoblastic leukemia and lymphoblastic lymphoma. Cancer Discov. 2021;11(6):1440–1453.
Gibson A, Trabal A, McCall D, Khazal S, Toepfer L, Bell DH, et al. Venetoclax for children and adolescents with acute lymphoblastic leukemia and lymphoblastic lymphoma. Cancers (Basel). 2021;14(1):150.
Marinoff AE, Aaronson K, Agrawal AK, Braun BS, Golden C, Huang BJ, et al. Venetoclax in combination with chemotherapy as treatment for pediatric advanced hematologic malignancies. Pediatr Blood Cancer. 2023;10:e30335.
Masetti R, Baccelli F, Leardini D, Gottardi F, Vendemini F, Di Gangi A, et al. Venetoclax‐based therapies in pediatric advanced MDS and relapsed/refractory AML: a multicenter retrospective analysis. Blood Adv. 2023;7(16):4366–4370.
Niswander LM, Chung P, Diorio C, Tasian SK. Clinical responses in pediatric patients with relapsed/refractory leukemia treated with azacitidine and venetoclax. Haematologica. 2023;108(11):3142–3147.
Bobeff K, Pastorczak A, Urbanska Z, Balwierz W, Juraszewska E, Wachowiak J, et al. Venetoclax use in paediatric haemato‐oncology centres in Poland: a 2022 survey. Children (Basel). 2023;10(4):745.
Badawi MA, Gopalakrishnan S, Engelhardt B, Palenski TL, Kim SY, Karol SE, et al. Proposed scheme for dosing venetoclax in pediatric patients with relapsed/refractory acute myeloid leukemia: analysis of developmental pharmacokinetics and exposure‐response relationships. Blood. 2020;136(Suppl. 1):11–12.
Zhang K, Zhang X, Xu Y, Xue S, Qiu H, Tang X, et al. Efficacy of venetoclax combined with hypomethylating agents in young, and unfit patients with newly diagnosed core binding factor acute myeloid leukemia. Blood Cancer J. 2023;13(1):155.
Abbas HA, Ayoub E, Sun H, Kanagal‐Shamanna R, Short NJ, Issa G, et al. Clinical and molecular profiling of AML patients with chromosome 7 or 7q deletions in the context of TP53 alterations and venetoclax treatment. Leuk Lymphoma. 2022;63(13):3105–3116.
Kivioja JL, Thanasopoulou A, Kumar A, Kontro M, Yadav B, Majumder MM, et al. Dasatinib and navitoclax act synergistically to target NUP98‐NSD1+/FLT3−ITD+ acute myeloid leukemia. Leukemia. 2019;33(6):1360–1372.

Auteurs

Abbie Wilson (A)

Department of Haematology, Great Ormond Street Hospital for Children, London, UK.

Ahmed Moussa (A)

Department of Haematology, Great Ormond Street Hospital for Children, London, UK.

Amélie Trinquand (A)

National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.

Andrea Malone (A)

National Children's Cancer Service, Children's Health Ireland at Crumlin, Dublin, Ireland.

Sanjay Tewari (S)

The Royal Marsden Hospital, London, UK.

Richard Calvert (R)

The Sheffield Children's Hospital, Sheffield, South Yorkshire, UK.

Katharine Patrick (K)

The Sheffield Children's Hospital, Sheffield, South Yorkshire, UK.

Emma Nicholson (E)

The Royal Marsden Hospital, London, UK.
Institute of Cancer Research, London, UK.

Katy Smith (K)

The Royal Marsden Hospital, London, UK.

Victoria Grandage (V)

University College Hospital London, London, UK.

Susan Baird (S)

The Royal Hospital for Sick Children, Edinburgh, Scotland, UK.

Lindsay George (L)

University Hospitals Birmingham NHS Trust, Birmingham, UK.

Amrana Qureshi (A)

Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Albert Borg (A)

The Royal Hospital for Children, Glasgow, UK.

Brenda Gibson (B)

The Royal Hospital for Children, Glasgow, UK.

Pritesh Patel (P)

Great Ormond Street Hospital for Children, London, UK.

Jack Bartram (J)

Department of Haematology, Great Ormond Street Hospital for Children, London, UK.

Lamia Samrin (L)

Great Ormond Street Hospital for Children, London, UK.

David O'Connor (D)

Department of Haematology, Great Ormond Street Hospital for Children, London, UK.
UCL Great Ormond Street Institute of Child Health, London, UK.

Classifications MeSH