Venetoclax-based therapy for relapsed or refractory acute myeloid leukaemia following intensive induction chemotherapy

Daniel Tuyet Kristensen*, Rasmus Froberg Brøndum, Andreas Due Ørskov, Claus Werenberg Marcher, Claudia Schöllkopf, Anne Louise Tølbøll Sørensen, Marianne Tang Severinsen, Martin Bøgsted, Anne Stidsholt Roug

*Corresponding author for this work

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Abstract

Background: The treatment of relapsed or refractory (R/R) acute myeloid leukaemia (AML) remains challenging and outcomes extremely poor. The introduction of venetoclax has transformed the treatment of AML and emerging data suggest that venetoclax-based therapy may enforce salvage treatment. Materials and Methods: In this nationwide Danish retrospective study, we analysed treatment outcomes of venetoclax-based salvage treatment for R/R AML between 2019 and 2022. Only venetoclax-naive patients who had previously received treatment with intensive chemotherapy therapy were included. Results: The cohort consisted of 43 R/R patients with a median age of 57 years. Nine (20.9%) were primary refractory and 34 (79.1%) patients had relapsed, including 21 after previous allogeneic stem cell transplantation. The overall response rate was 76.2% including 61.9% with composite complete remission (CRc: CR + CRi). Among CRc-responders with information on measurable residual disease (MRD), 8/13 (61.5%) obtained an MRD-negativity response. The overall survival was 9.3 months for all patients with an estimated 1-year overall survival of 34%. For CRc-responders the median overall survival was 13.3 months, and the median relapse-free survival was 12.8 months. Conclusion: Venetoclax-based salvage treatment for R/R AML produced high response rates; however, for most patients the response was of limited duration. This study is limited by an observational design and prone to selection bias.

Original languageEnglish
JournalEuropean journal of haematology
Volume111
Issue number4
Pages (from-to)573-582
ISSN0902-4441
DOIs
Publication statusPublished - Oct 2023

Keywords

  • acute myeloid leukaemia
  • BCL-2
  • measurable residual disease
  • relapse/refractory
  • venetoclax

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