Venetoclax-based chemotherapy in acute and chronic myeloid neoplasms: literature survey and practice points

作者: Naseema Gangat , Ayalew Tefferi

DOI: 10.1038/S41408-020-00388-X

关键词:

摘要: Venetoclax (VEN), a small-molecule inhibitor of B cell leukemia/lymphoma-2, is now FDA approved (November 2018) for use in acute myeloid leukemia (AML), specific to newly diagnosed elderly or unfit patients, combination with hypomethylating agent (HMA; including azacitidine decitabine) low-dose cytarabine. A recent phase-3 study compared VEN combined either placebo, the aforementioned population; complete remission (CR) and CR incomplete count recovery (CRi) rates were 28.3% 66.4%, respectively, an improvement overall survival was also demonstrated. VEN-based chemotherapy has shown activity relapsed/refractory AML (CR/CRi 33-46%), high-risk myelodysplastic syndromes (CR 39% treatment naive, 5-14% HMA failure), blast-phase myeloproliferative neoplasm 25%); all instances, additional fraction patients met less stringent criteria response. Regardless, venetoclax-induced remissions often short-lived (less than year) but long enough allow some transition allogeneic stem transplant. Herein, we review current literature on therapy both chronic malignancies provide outline procedures follow at our institution drug administration, monitoring adverse events dose adjustments.

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