医学
阿扎胞苷
内科学
文
威尼斯人
化疗
肿瘤科
挽救疗法
移植
外科
白血病
基因表达
慢性淋巴细胞白血病
DNA甲基化
化学
基因
生物化学
计算机科学
计算机安全
作者
Daniel A. Pollyea,Amanda Winters,Christine M. McMahon,Marc Schwartz,Craig T. Jordan,Rachel Rabinovitch,Clayton A. Smith,Jonathan A. Gutman
标识
DOI:10.1038/s41409-021-01476-7
摘要
The combination of venetoclax (ven) and azacitidine (aza) has resulted in high response rates in the upfront treatment of AML in patients age > 75 and patients unfit for intensive chemotherapy. Given the poor historical outcomes in patients age ≥ 60 treated with induction chemotherapy, ven/aza has become our institutional preference for the initial treatment of non-core binding factor (CBF) AML patients age ≥ 60. The benefit of allogeneic stem cell transplant (SCT) in patients who achieve response to ven/aza is uncertain. We report outcomes of SCT-eligible patients treated at our center. Between 1/2015 and 1/2020, 119 newly diagnosed non-CBF AML patients age ≥ 60 received ven/aza as initial therapy. 21 patients underwent SCT; 31 additional patients were potentially SCT eligible but deferred SCT. Overall survival (OS) was significantly greater among SCT patients (median survival not reached) versus potentially SCT eligible patients not undergoing SCT (median 518 days) (p = 0.01). Our data suggest that ven/aza followed by SCT in newly diagnosed AML patients older than ≥ 60 results in excellent outcomes and likely improves outcomes over maintenance therapy. Ongoing investigation will further refine the optimal timing of and selection of patients for SCT based on prognostic disease features and response assessments.
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