Venetoclax with decitabine versus decitabine monotherapy in elderly acute myeloid leukemia: a propensity score-matched analysis

• DOI: 10.1038/s41408-022-00770-x
• Publication Date: 2022-12-19T03:09:48Z
• Authors: Daehun Kwag; Byung-Sik Cho; Su-Yeon Bang; Jong Hyuk Lee; Gi-June Min; Sung-Soo Park; Silvia Park; Jae-Ho Yoon; Sung-Eun Lee; Ki-Seong Eom; Yoo-Jin Kim; Seok Lee; Chang-Ki Min; Seok-Goo Cho; Jong Wook Lee; Hee-Je Kim
• Keywords: Decitabine; Ven; Azacitidine; Venetoclax

Abstract Venetoclax (VEN) combined with azacitidine (AZA) or decitabine (DEC) has been approved for older adults acute myeloid leukemia (AML) unfit intensive chemotherapy based on the pivotal VIALE-A trial. However, this trial only compared AZA + VEN monotherapy. Therefore, we outcomes of consecutive (65 years older) newly diagnosed AML who received DEC ( n = 230) 74) after propensity score matching to construct a one-to-one matched cohort by nearest neighbor algorithm. The median overall survival was longer in group than (13.4 months vs. 8.3 months, p 0.01). event-free survivals were 8.6 and 5.8 groups, respectively 0.02). response rate (complete response, complete incomplete hematologic recovery, morphologic leukemia-free state) significantly higher (70.3% 24.3%, < 30-day (2.7% 9.5%, 0.17) 60-day (9.5% 18.9%, 0.16) mortality rates did not differ between two nor hospitalization transfusion (hospitalization: 23 days 21 days, 0.20; red blood cells: 3.2 units/month 3.5 units/month, 0.73; platelets: 2.7 2.3 units/months, 0.48). Of those became leukemia-free, 29% underwent allogeneic stem cell transplantation had excellent (one-year survival: 79.4%; one-year non-relapse mortality: 13.3%). This study is first provide real-world evidence that superior