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Impact of previous anthracycline therapy in patients with acute myeloid leukemia receiving venetoclax

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Abstract

Venetoclax (VEN) combination regimens are now recognized as effective against acute myeloid leukemia (AML). However, the prognosis of patients who do not attain a composite complete response (cCR) is extremely poor, and clinical determinants of response remain unknown. Medical records of 57 patients with AML treated with VEN combination regimens from April 2021 to March 2022 at six institutions were retrospectively analyzed. The primary endpoint was cCR, complete remission, or complete remission with incomplete hematologic recovery after one cycle of VEN combination regimen. Five patients had previously relapsed after allogeneic hematopoietic stem cell transplantation (allo-SCT). The treatment regimen was azacitidine–VEN in 48 patients (84%) and low-dose cytarabine–VEN in 9 patients (16%). Thirty patients (53%) achieved cCR after one cycle of a VEN regimen. In univariate analysis, the number of prior chemotherapy regimens, post-allo-SCT relapse, and cytogenetic risk category were associated with a decreased likelihood of achieving cCR. In multivariate analysis, second-line chemotherapy remained a significant predictor of response. Patients who received anthracycline immediately before the VEN regimen had a higher cCR rate than patients who did not receive anthracycline. In this study, prior chemotherapy/allo-SCT and cytogenetic risk were associated with VEN treatment outcomes.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for providing excellent English language editing assistance. The results of this study were presented in part at the 84th Japanese Society of Hematology Annual Meeting in Fukuoka, Japan, on October 16, 2022.

Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan

    Ryujiro Hara, Shinichiro Machida, Daisuke Ogiya, Hidetsugu Kawai, Shohei Kawakami, Sawako Shiraiwa, Makoto Onizuka, Yoshiaki Ogawa, Hiroshi Kawada & Kiyoshi Ando

  2. Department of Hematology, Ebina General Hospital, Ebina, Kanagawa, Japan

    Ryujiro Hara

  3. Department of Hematology, Ozawa Hospital, Odawara, Kanagawa, Japan

    Ryujiro Hara & Shohei Kawakami

  4. Department of Hematology/Oncology, Tokai University Hachioji Hospital, Tokyo, Japan

    Norisato Hashimoto

  5. Department of Hematology, Isehara Kyodo Hospital, Isehara, Kanagawa, Japan

    Daisuke Ogiya

  6. Department of Hematology, Hiratsuka Kyosai Hospital, Hiratsuka, Kanagawa, Japan

    Hidetsugu Kawai

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  1. Ryujiro Hara
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  2. Shinichiro Machida
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Contributions

RH designed the study. RH, SM, NH, DO, HK, and SK recruited the patients and collected the data. RH analyzed the data. RH, SS, MO, YO, HK, and KA wrote the draft of the manuscript. All authors were involved in revising the manuscript and approved the final version of the manuscript.

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Correspondence to Ryujiro Hara.

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Hara, R., Machida, S., Hashimoto, N. et al. Impact of previous anthracycline therapy in patients with acute myeloid leukemia receiving venetoclax. Int J Hematol 118, 711–717 (2023). https://doi.org/10.1007/s12185-023-03664-1

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  • DOI: https://doi.org/10.1007/s12185-023-03664-1

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