Venetoclax-Based Regimen for Elderly Patients with Acute Myeloid Leukemia: A Real-World Experience from a Tertiary Center in Taiwan

Background: Venetoclax, in combination with a hypomethylating agent or low-dose cytarabine, is approved for the treatment of acute myeloid leukemia (AML) in elderly patients or in those who are in-eligible for intensive chemotherapy. The aim of our study was to investigate whether the venetoclax-containing regimen improved the survival of elderly AML patients in Taiwan.Patients and methods: Thirty-two elderly patients (>= 60 years) diagnosed with AML at our hospital from January 2018 to October 2022 were retrospectively enrolled. Clinical characteristics and molecular pro-files of the patients were captured by chart review. All statistical analyses were calculated by using MedCalc Statistical Software.Results: The median overall survival (OS) of our entire cohort was 4.0 months (95% confidence interval, 1.13-33.3 months). Patients receiving venetoclax-containing regimens or the best available therapy (BAT) had median OS of 33.3 months and 1.5 months, respectively (p < 0.001). The response rate of the venetoclax-containing regimen was 68.8% (11/16). Three patients treated with venetoclax underwent allogeneic peripheral blood stem cell transplantation and remained in remission at the last follow-up. Patients aged 75 years or older who were treated with venetoclax-containing regimens had better survival when compared to those who received BAT (11.3 months vs. 0.4 months, p = 0.018). Multivariate analysis showed that elderly AML patients aged 75 years or younger and those receiving venetoclax-containing regimens were 2 independent good prognostic factors for OS.Conclusion: Venetoclax-based regimens prolonged the survival of elderly AML patients in Taiwan, even in those aged 75 years or older. Copyright (c) 2023, Taiwan Society of Geriatric Emergency & Critical Care Medicine.