Zhongguo quanke yixue (Mar 2022)

Clinical Study of Venetoclax with Chemotherapy for Relapsed/Refractory Acute Myeloid Leukemia

  • CHEN Xiaofeng, WANG Meng, LI Zhongyu, LI Jiajia

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.02.005
Journal volume & issue
Vol. 25, no. 08
pp. 957 – 962

Abstract

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BackgroundAdults with relapsed/refractory acute myeloid leukemia (AML) have poor prognosis, very low long-term survival rate and cure rate, and limited chemotherapy regimens.ObjectiveTo investigate the safety and efficacy of venetoclax (VEN) with HAAG 〔homoharringtonine (HHT) , Cytarabine (Ara-C) , aclacinomycin (Acla) , granulocyte stimulating factor (G-CSF) 〕 in relapsed/refractory AML.MethodsThe clinical data of 10 adult patients with relapsed/refractory AML treated in the First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively, including: clinical characteristics (sex, age, diagnosis, chromosome, gene mutation, prognosis) , peripheral blood and bone marrow cytology, and the effect of Ven+Aza+HAAG regimen.ResultsAmong the 10 patients, there were 7 men and 3 women, with an average age of (47.9±11.3) years; 4 cases of M2 and 6 cases of M5 by FAB classification; 3 cases of good prognosis, 2 cases of fair and 5 cases of poor. The median levels of WBC count, hemoglobin content, and platelet count, as well as median percentage of bone marrow blast cells before chemotherapy of the patients were 4.10×109/L, 87.5 g/L, 66.00×109/L, and 63.5%, respectively, and after chemotherapy, the values of these four indicators were 3.28×109/L, 107.0 g/L, 78.00×109/L and 5.5%, respectively. Before VEN+Aza+HAAG regimen combined chemotherapy, the median number of chemotherapy used by the patients was 5. And after the combined therapy, there were 1 case of complete remission (CR) and 4 cases of CR with incomplete count recovery (CRi) , 3 cases of partial remission (PR) , and 2 cases of non-remission (NR) . The objective response rate of 10 patients was 80%, and median survival time was 〔6.5 (3.0, 8.5) 〕months. The toxic and side effects were mainly bone marrow suppression and infection. No patients died of treatment-related complications and other toxic and side effects.ConclusionCompared with traditional chemotherapy regimen, the use of Ven + Aza + HAAG with chemotherapy could significantly improve the objective response rate and remission degree, and prolong the survival in patients with relapsed/refractory AML, which is worthy of further study and has a prospect of clinical application.

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