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Chatzilygeroudi T, Darmani I, El Gkotmi N, Vryttia P, Douna S, Bouchla A, Labropoulou V, Kotsopoulou M, Symeonidis A, Pagoni M, Pappa V, Papageorgiou SG. Real-Life Multicenter Experience of Venetoclax in Combination with Hypomethylating Agents in Previously Untreated Adult Patients with Acute Myeloid Leukemia in Greece. J Clin Med 2024; 13:584. [PMID: 38276092 PMCID: PMC10816211 DOI: 10.3390/jcm13020584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The landscape of first-line treatment for acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy has changed remarkably after venetoclax approval. Accumulating real-world data further apprises us with more knowledgeable use. To assess the efficacy and safety challenges in the real-life setting of the combination of hypomethylated agent (HMA) and venetoclax, we conducted a multi-center retrospective study. METHODS Forty adult AML patients treated with the combination of HMA and venetoclax as a first-line treatment after full approval (2020) were included. To confirm VIALE-A results, this group was compared to a historical cohort of 17 chemotherapy-ineligible AML patients treated with HMA monotherapy before 2020. RESULTS The combination of HMA-venetoclax achieved a composite complete response rate of 86.8% (p < 0.001), median overall survival, and event-free survival of 33.8 and 19.7 months, respectively, in a median follow-up of 17.8 months (pos < 0.001, HR = 0.276, CI: 0.132-0.575, pEFS = 0.004, HR = 0.367, CI: 0.174-0.773). High rates of neutropenia (90%) and consequent infection rates (57.5%) were noted. Only 55% of our patients received antifungal prophylaxis, as its use remains controversial, and invasive fungal infections were presented in 7.5%. CONCLUSIONS Evidently, venetoclax-HMA yields high response rates and profound survival benefits in real life and has changed our approach to alternative chemotherapy options.
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Affiliation(s)
- Theodora Chatzilygeroudi
- Hematology Division, Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Patras, 30100 Patras, Greece; (T.C.); (V.L.); (A.S.)
| | - Ismini Darmani
- Hematology Department, Evaggelismos General Hospital, 10676 Athens, Greece; (I.D.); (N.E.G.); (M.P.)
| | - Natali El Gkotmi
- Hematology Department, Evaggelismos General Hospital, 10676 Athens, Greece; (I.D.); (N.E.G.); (M.P.)
| | - Pinelopi Vryttia
- Hematology Unit, Second Department of Internal Medicine, and Research Institute, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (P.V.); (A.B.); (V.P.)
| | - Stavroula Douna
- Hematology Department, Metaxa General Hospital, 18537 Peiraeus, Greece; (S.D.); (M.K.)
| | - Anthi Bouchla
- Hematology Unit, Second Department of Internal Medicine, and Research Institute, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (P.V.); (A.B.); (V.P.)
| | - Vasiliki Labropoulou
- Hematology Division, Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Patras, 30100 Patras, Greece; (T.C.); (V.L.); (A.S.)
| | - Maria Kotsopoulou
- Hematology Department, Metaxa General Hospital, 18537 Peiraeus, Greece; (S.D.); (M.K.)
| | - Argiris Symeonidis
- Hematology Division, Department of Internal Medicine, School of Health Sciences, Faculty of Medicine, University of Patras, 30100 Patras, Greece; (T.C.); (V.L.); (A.S.)
| | - Maria Pagoni
- Hematology Department, Evaggelismos General Hospital, 10676 Athens, Greece; (I.D.); (N.E.G.); (M.P.)
| | - Vasiliki Pappa
- Hematology Unit, Second Department of Internal Medicine, and Research Institute, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (P.V.); (A.B.); (V.P.)
| | - Sotirios G. Papageorgiou
- Hematology Unit, Second Department of Internal Medicine, and Research Institute, Medical School, University General Hospital “Attikon”, National and Kapodistrian University of Athens, 12462 Athens, Greece; (P.V.); (A.B.); (V.P.)
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