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Hypomethylating agents plus modified priming regimens compared with venetoclax-based regimens based on molecular characteristics for newly diagnosed patients with acute myeloid leukemia: a multi-center cohort study.
Weng, Guangyang; Huang, Jingya; He, Xin; Xue, Tingting; Yang, Linlin; Zhang, Yu; Yu, Guopan; Sun, Zhiqiang; Lin, Dongjun; Deng, Lan; Liang, Xinquan; Xiao, Jie; Zhang, Hongyu; Guo, Ziwen; Jin, Hua; Liu, Qifa; Du, Xin.
Afiliación
  • Weng G; Department of Hematology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
  • Huang J; Shenzhen Blood Center, Shenzhen, Guangdong, China.
  • He X; Department of Hematology, Zhongshan City People's Hospital, Zhongshan, China.
  • Xue T; Department of Hematology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
  • Yang L; Department of Hematology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
  • Zhang Y; Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Yu G; Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Sun Z; Department of Hematology, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
  • Lin D; Department of Hematology, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.
  • Deng L; Department of Hematology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Liang X; Department of Hematology, The First People's Hospital of Chenzhou, Chenzhou, China.
  • Xiao J; Department of Hematology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
  • Zhang H; Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, China.
  • Guo Z; Department of Hematology, Zhongshan City People's Hospital, Zhongshan, China.
  • Jin H; Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
  • Liu Q; Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China. liuqifa628@163.com.
  • Du X; Department of Hematology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China. duxingz@medmail.com.cn.
Ann Hematol ; 102(12): 3369-3381, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37723307
Venetoclax (VEN)-based regimens are the standard of care for elderly or unfit patients with newly diagnosed (ND) acute myeloid leukemia (AML). Some single-arm studies have implied that hypomethylating agents (HMAs) plus priming regimens may potentially provide an alternative therapeutic approach, owing to encouraging efficacy seen. However, no comparative data exists yet regarding these two treatment approaches. In this retrospective multi-center cohort study, we enrolled 294 ND AML patients, allocating 167 to the HMA + priming group and 127 to the VEN-based group. Treatment response and overall survival (OS) were compared between groups. Molecular subgroup analyses were also conducted. With a median of two cycles for HMA + priming group, the overall response (ORR) was 65.3%, including 55.1% complete remission (CR), 9.6% CR with incomplete hematologic recovery (CRi) and 0.6% morphologic leukemia-free state (MLFS). With a median of two cycles for VEN-based group, the ORR was 70.9%, including 46.5% CR, 18.9% CRi, and 5.5% MLFS. Response differences (ORR or CR/CRi) between groups were not significant (p > 0.05). With a median follow-up of 10.1 months, median OSs were similar between groups (20.9 vs 16.3 months, p = 0.41). However, VEN regimens demonstrated superior CR/CRi for patients with mutations in FLT3, IDH1/2, and NPM1 compared to HMA + priming (80.0% vs 35.0%, p = 0.01; 90.9% vs 65.5%, p = 0.02; 90.9% and 65.5%, p = 0.02, respectively). In conclusion, HMAs plus modified priming regimens might be a potential alternative therapeutic approach for patients with ND AML, but VEN-based regimens presented predominance in specific molecular subgroups. Molecular characteristics contribute to guiding choice of treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies Límite: Aged / Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Observational_studies Límite: Aged / Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania