Abstract 783P
Background
We conducted a retrospective analysis of patients with newly diagnosed acute myeloid leukemia (AML) who received either Venetoclax plus azacitidine (Ven/Aza, n = 14) or Mini intensive chemotherapy (MC, n = 11). The goal was to compare outcomes, identify predictors of response, and refine treatment recommendations. These treatments are options for AML patients not eligible for intensive chemotherapy.
Methods
A total of 25 patients with non-acute promyelocytic AML seen at continental hospitals from 2019-2023 were included. Criteria were no prior therapy, complete diagnostic work-up for ELN classification, at least one dose of a planned regimen, and follow-up to response assessment or death. Mini conditioning was cytarabine 100 mg/m2/day for 5 days plus daunorubicin 60 mg/m2 for 1 day. Azacitidine was 100 mg for 7 days subcutaneously or 300 mg orally for 7 days, and Venetoclax was 100 mg for 14/21 days with a 1-week gap based on cytopenia.
Results
Baseline characteristics showed no significant differences in sex distribution, median age, and median bone marrow blast percentage between Ven/Aza (n = 14) and MC (n = 11) groups. Significant differences were noted in KMT2A rearrangements (p < .0001), FLT3 ITD (14% vs. 9%, p = .03), and NPM1 mutation (21% vs. 9%, p = .02). Response rates, complete remission (CR), and death within 30 days were similar. Ven/Aza required fewer PRBCs (7 vs. 9 units) but more SDPs (9 vs. 6 units, p = 0.05). Toxicities differed significantly (p = 0.03), with more Grade I/II in Ven/Aza (57% vs. 18%) and more Grade III/IV in MC (43% vs. 82%), and febrile neutropenia requiring ICU care was more common in MC (46% vs. 21%, p = 0.04).
Conclusions
Our retrospective analysis showed that response rates and 30-day mortality were similar between Ven/Aza and MC groups. Ven/Aza required fewer PRBCs but more SDPs and was associated with higher Grade I/II toxicities. In contrast, MC had more severe Grade III/IV toxicities and higher ICU care needs for febrile neutropenia. These findings align with existing literature, highlighting Ven/Aza’s favorable efficacy and tolerability profile compared to intensive chemotherapy, supporting its use in patients unsuitable for intensive treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.