How We Incorporate Venetoclax in Treatment Regimens for Acute Myeloid Leukemia

被引：16

作者：

Maiti, Abhishek ^{[1
]}

Konopleva, Marina Y. ^{[1
]}

机构：

[1] Univ Texas MD Anderson Canc Ctr, Dept Leukemia, 1400 Holcombe Blvd,Unit 428, Houston, TX 77030 USA

来源：

CANCER JOURNAL | 2022年 / 28卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Acute myeloid leukemia; azacitidine; chemotherapy; decitabine; venetoclax; LOW-DOSE CYTARABINE; RISK MYELODYSPLASTIC SYNDROME; OLDER PATIENTS; SINGLE-CENTER; INTENSIVE CHEMOTHERAPY; OPEN-LABEL; BCL-2; INHIBITION; ELDERLY-PATIENTS; PHASE-III; AZACITIDINE;

D O I：

10.1097/PPO.0000000000000567

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Venetoclax has transformed the therapeutic landscape of acute myeloid leukemia (AML). Hypomethylating agents with venetoclax (HMA-VEN) have significantly improved outcomes and have become the standard therapy for older/unfit patients with newly diagnosed AML and are comparable to intensive chemotherapy in salvage setting. Venetoclax with intensive chemotherapy have shown high response rates in both frontline and salvage setting in younger patients, and triplet combinations with HMA-VEN and FLT3 inhibitors have shown encouraging results in FLT3(mut) AML. While patients with NPM1(mut), IDH1/2(mut) experience favorable outcomes, those with TP53(mut) and secondary AML may experience minimal benefit from the addition of venetoclax. Despite improved outcomes, severe cytopenias and infectious complications are common with venetoclax-based regimens. Early response evaluation, dose reductions, venetoclax interruptions, use of growth factors, and prophylactic antimicrobials may minimize such myelosuppression and risk of infections. Outcomes after failure of frontline HMA-VEN are dismal, and novel approaches are needed to abrogate primary and acquired resistance.

引用

页码：2 / 13

页数：12

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