Outcomes of relapsed or refractory acute myeloid leukemia patients failing venetoclax‐based salvage therapies

Outcomes of relapsed or refractory acute myeloid leukemia patients failing venetoclax‐based salvage therapies

Objectives and methods We conducted a retrospective analysis to evaluate the outcomes of 28 heavily pretreated (median 3 (2‐6) treatment lines, sixteen (57%) allotransplanted) relapsed/refractory acute myeloid leukemia patients who had failed salvage venetoclax‐based therapies. Results The median ag...

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Published in:European journal of haematology Vol. 106; no. 1; pp. 105 - 113
Main Authors: Zucenka, Andrius, Pileckyte, Regina, Trociukas, Igoris, Peceliunas, Valdas, Vaitekenaite, Vilmante, Maneikis, Kazimieras, Davainis, Linas, Zvirblis, Tadas, Stoskus, Mindaugas, Gineikiene, Egle, Norvilas, Rimvydas, Dirse, Vaidas, Surauciute, Agne, Zucenkiene, Emile, Griskevicius, Laimonas
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-01-2021
Subjects:
Acute myeloid leukemia
Chemotherapy
Cytarabine
Leukemia
Myeloid leukemia
Remission
Runx1 protein
Survival
acute myeloid leukemia
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Summary:Objectives and methods We conducted a retrospective analysis to evaluate the outcomes of 28 heavily pretreated (median 3 (2‐6) treatment lines, sixteen (57%) allotransplanted) relapsed/refractory acute myeloid leukemia patients who had failed salvage venetoclax‐based therapies. Results The median age was 59 years (20‐80), 20 patients (71%) had ECOG 2‐4 status, and 18 patients (64%) were stratified to European Leukemia Network 2017 adverse risk group. The most common mutations were ASXL1 (21%), RUNX1 (18%), FLT3 ITD/TKD (18%), PTPN11 (15%), NRAS/KRAS (15%), and WT1 (15%). Twenty‐two patients (79%) received different post‐venetoclax salvage therapies with the overall response rate of 23% (complete remission + morphological leukemia‐free state). Three of six (50%) patients achieved complete remissions after therapy with venetoclax + actinomycin D ± low‐dose cytarabine. The remaining 6 patients did not receive any further salvage treatment mainly due to poor general condition. The median overall survival was 3.9 months for all patients (4.3 for those receiving post‐venetoclax salvage vs 1.3 months receiving palliative care alone, P < .001). Conclusions Though the remission rate and survival of patients failing venetoclax are poor, a small proportion of these R/R AML patients may still respond to cautious intensification of chemotherapy with venetoclax.
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ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.13527