VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE

Objective: The response of elderly patients with acute myeloid leukemia (AML) to standard induction therapy is quite poor due to higher frequency of adverse genomic features, increased resistance to treatments, comorbidities and performance status. BCL-2 overexpression is implicated in survival of A...

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Autores principales:	Melda Cömert, Tuba Bulduk, Bilge Uğur, Murat Yıldırım, Selim Sayın, Alparslan Merdin, Ebru Kılıç Güneş, Elifcan Aladağ Karakulak, Meltem Aylı
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/8b18364c97ed43b6bd1a68128e0a4314
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spelling	oai:doaj.org-article:8b18364c97ed43b6bd1a68128e0a43142021-11-10T04:34:34ZVENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE2531-137910.1016/j.htct.2021.10.1012https://doaj.org/article/8b18364c97ed43b6bd1a68128e0a43142021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2531137921011597https://doaj.org/toc/2531-1379Objective: The response of elderly patients with acute myeloid leukemia (AML) to standard induction therapy is quite poor due to higher frequency of adverse genomic features, increased resistance to treatments, comorbidities and performance status. BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Preclinical data demonstrated the anti-leukemic effect of venetoclax, a selective BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Methodology: Venetoclax has received FDA approval for the treatment of AML patients >75 years of age and in combination with hypomethylating agents/low-dose cytarabine in patients not eligible for intensive therapy. Six newly diagnosed AML patients who were followed up in Gülhane Education and Training Hospital, Hematology clinic and treated with azacitidine+venetoclax were evaluated retrospectively. Results: F/M:1/5,the mean age was 77.3 (63-87).Two patients were secondary AML.All patients had normal karyotype.Venetoclax+azacytidine treatment was started in all patients as first-line treatment after obtaining off-label consent.The average number of courses of venetoclax + azacitidine administered 3.5 (1-8).Patients received 200 mg/day venetoclax because of fluconazole usage concomittantly.One patient died with a FEN attack at the end of the second cycle, and 5 patients are still being followed up. Conclusion: Azacitidine or decitabine monotherapy yields low response rates (10%-50%, including hematologic improvement), require 3.5 to 4.3 months to achieve best response, and are not curative, with a median OS of less than 1 year.Targeted therapies capable of rapidly inducing a high rate of clinical response, with better tolerability and durable responses for elderly patients with AML. The novel combination of venetoclax with decitabine or azacitidine was effective and well tolerated in elderly patients.Melda CömertTuba BuldukBilge UğurMurat YıldırımSelim SayınAlparslan MerdinEbru Kılıç GüneşElifcan Aladağ KarakulakMeltem AylıElsevierarticleDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss , Pp S33-S34 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Melda Cömert Tuba Bulduk Bilge Uğur Murat Yıldırım Selim Sayın Alparslan Merdin Ebru Kılıç Güneş Elifcan Aladağ Karakulak Meltem Aylı VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
description	Objective: The response of elderly patients with acute myeloid leukemia (AML) to standard induction therapy is quite poor due to higher frequency of adverse genomic features, increased resistance to treatments, comorbidities and performance status. BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Preclinical data demonstrated the anti-leukemic effect of venetoclax, a selective BCL-2 overexpression is implicated in survival of AML cells and treatment resistance. Methodology: Venetoclax has received FDA approval for the treatment of AML patients >75 years of age and in combination with hypomethylating agents/low-dose cytarabine in patients not eligible for intensive therapy. Six newly diagnosed AML patients who were followed up in Gülhane Education and Training Hospital, Hematology clinic and treated with azacitidine+venetoclax were evaluated retrospectively. Results: F/M:1/5,the mean age was 77.3 (63-87).Two patients were secondary AML.All patients had normal karyotype.Venetoclax+azacytidine treatment was started in all patients as first-line treatment after obtaining off-label consent.The average number of courses of venetoclax + azacitidine administered 3.5 (1-8).Patients received 200 mg/day venetoclax because of fluconazole usage concomittantly.One patient died with a FEN attack at the end of the second cycle, and 5 patients are still being followed up. Conclusion: Azacitidine or decitabine monotherapy yields low response rates (10%-50%, including hematologic improvement), require 3.5 to 4.3 months to achieve best response, and are not curative, with a median OS of less than 1 year.Targeted therapies capable of rapidly inducing a high rate of clinical response, with better tolerability and durable responses for elderly patients with AML. The novel combination of venetoclax with decitabine or azacitidine was effective and well tolerated in elderly patients.
format	article
author	Melda Cömert Tuba Bulduk Bilge Uğur Murat Yıldırım Selim Sayın Alparslan Merdin Ebru Kılıç Güneş Elifcan Aladağ Karakulak Meltem Aylı
author_facet	Melda Cömert Tuba Bulduk Bilge Uğur Murat Yıldırım Selim Sayın Alparslan Merdin Ebru Kılıç Güneş Elifcan Aladağ Karakulak Meltem Aylı
author_sort	Melda Cömert
title	VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
title_short	VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
title_full	VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
title_fullStr	VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
title_full_unstemmed	VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE
title_sort	venetoclax azacitidine combination therapy in first-line treatment of acute myeloid leukemia patients: a single center experience
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/8b18364c97ed43b6bd1a68128e0a4314
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VENETOCLAX AZACITIDINE COMBINATION THERAPY IN FIRST-LINE TREATMENT OF ACUTE MYELOID LEUKEMIA PATIENTS: A SINGLE CENTER EXPERIENCE

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