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934579.pdf (1.45 MB)

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2024-10-01

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cc-by (c) Jiménez Vicente, Carlos et al., 2024
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/228683

Clinical management of patients diagnosed with acute myeloid leukemia treated with venetoclax in combination with hypomethylating agents after achieving a response: a real-life study

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https://doi.org/10.1007/s00277-024-05923-5

Resum

Although there is an approved indication for venetoclax and hypomethylating agents (VenHMA) and its use in different AML settings will be expanded in the following years, the management of the adverse events (AEs) lacks of harmonized algorithms during treatment of these patients. We have studied the incidence of relevant AEs of 43 patients who achieved a response to VenHMA and its management. Median overall survival of our cohort was 19 months. No patients discontinued treatment due to AEs after C3D1, Regarding severe AEs, high rates of grade 4 neutropenia (97.6%) and grade 4 thrombocytopenia (65.1%) were observed. Severe infectious AEs rate was 16%. Due to severe myelotoxicity, most patients required a progressive dose reduction of both venetoclax and hypomethylating agents during follow-up, being 87.8% at C6D1. Transfusional dependence rate was 91% and G-CSF was prescribed to 86% of the patients. Finally, there was not a significant difference in hemoglobin, platelets and absolute neutrophil count after achieving complete response comparing paired samples during follow-up, although cytopenia rate was high during initial follow-up. We conclude that dose reduction of VenHMA after achieving a response in patients diagnosed with AML is required in most patients and essential to avoid prolonged cytopenia-related adverse events and a rapid and standardized method on how to perform it might decrease the AEs rate.

Matèries

Leucèmia mieloide, Terapèutica, Tractament adjuvant del càncer

Matèries (anglès)

Myeloid leukemia, Therapeutics, Adjuvant treatment of cancer

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

JIMÉNEZ VICENTE, Carlos, GUARDIA TORRELLES, Ares, PÉREZ VALENCIA, Amanda isabel, MARTÍNEZ-ROCA, Alexandra, CASTAÑO DÍEZ, Sandra, GUIJARRO TOMAS, Francisca, CORTÉS BULLICH, Albert, MERCHÁN, Beatriz, TRIGUERO, Ana, HERNÁNDEZ ALVAREZ, María isabel, BRILLEMBOURG, Helena, MUNÁRRIZ, Daniel, ZUGASTI, Inés, FERNÁNDEZ AVILÉS, Francesc, DÍAZ BEYÀ, Marina, ESTEVE, Jordi. Clinical management of patients diagnosed with acute myeloid leukemia treated with venetoclax in combination with hypomethylating agents after achieving a response: a real-life study. _Annals of Hematology_. 2024. Vol. 103, núm. 10, pàgs. 4033-4043. [consulta: 6 de maig de 2026]. ISSN: 0939-5555. [Disponible a: https://hdl.handle.net/2445/228683]

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