Evaluation Of Hypomethylating Agent Venetoclax Combination In Patients With Acute Myeloid Leukaemia Ineligible For Intensive Treatment

Tuğcan Alp Kırkızlar; Ahmet Muzaffer Demir

Article Details

Evaluation Of Hypomethylating Agent Venetoclax Combination In Patients With Acute Myeloid Leukaemia Ineligible For Intensive Treatment

Authors:

Tuğcan Alp Kırkızlar | Ahmet Muzaffer Demir

Publisher:

Eskişehir Osmangazi University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Osmangazi Tıp Dergisi Vol.46 Issue 2, pp.275-283

Document Type:

Article

Publication Date:

3/2024

Document Language:

Turkish

Document ID (Org No.):

2001306817

pISSN:

1305-4953

Keywords:

Abstract:

 : In acute myeloid leukaemia AML, which the median age at diagnosis is 68 years, survival is significantly lower in the elderly group who are ineligible for intensive treatment. Survival and quality of life have been improved with the combination of the hypomethylating agent venetoclax HMA-V, which has become the standard of care for this group of patients. We aimed to evaluate the results of HMA-V combination therapy in the group of AML patients who are ineligible for intensive treatment at our centre. The median age of the 37 patients included in the study was 70.2 years, and 51.4 were women. 73 of the patients were de novo leukemia while 4 patients were relapse and 1 was refractory disease. The HMA-V combination was given 2 patients who were in remission due to intoleranceside effects of intensive treatment. Azacitidine usage rate was 78.6. The median number of course was 3. The remission rate was found to be 51.4 in bone marrow evaluation at the end of the 1st2nd course. The mean follow-up was 11.9 months and 56.75 of patients died. Mean survival was 27.1, 4.1 and 7.5 months for those who achieved remission, those who did not achieve remission and those who could not be assessed, respectively, with a significant difference between groups p 0.001. While mean and median survival with azacitidine were 22.03 and 23 months, with decitabine 3.87 and 3 months respectively, there was a significant statistical difference p0.001. In multivariate Cox regression analysis, the only factor influencing mortality was not being in remission at the end of 1st2nd cycle assessment. In conclusion, the survival and remission rates seen in our center are found to be similar to real-world studies.

 : In acute myeloid leukaemia AML, which the median age at diagnosis is 68 years, survival is significantly lower in the elderly group who are ineligible for intensive treatment. Survival and quality of life have been improved with the combination of the hypomethylating agent venetoclax HMA-V, which has become the standard of care for this group of patients. We aimed to evaluate the results of HMA-V combination therapy in the group of AML patients who are ineligible for intensive treatment at our centre. The median age of the 37 patients included in the study was 70.2 years, and 51.4 were women. 73 of the patients were de novo leukemia while 4 patients were relapse and 1 was refractory disease. The HMA-V combination was given 2 patients who were in remission due to intoleranceside effects of intensive treatment. Azacitidine usage rate was 78.6. The median number of course was 3. The remission rate was found to be 51.4 in bone marrow evaluation at the end of the 1st2nd course. The mean follow-up was 11.9 months and 56.75 of patients died. Mean survival was 27.1, 4.1 and 7.5 months for those who achieved remission, those who did not achieve remission and those who could not be assessed, respectively, with a significant difference between groups p 0.001. While mean and median survival with azacitidine were 22.03 and 23 months, with decitabine 3.87 and 3 months respectively, there was a significant statistical difference p0.001. In multivariate Cox regression analysis, the only factor influencing mortality was not being in remission at the end of 1st2nd cycle assessment. In conclusion, the survival and remission rates seen in our center are found to be similar to real-world studies.

 : In acute myeloid leukaemia AML, which the median age at diagnosis is 68 years, survival is significantly lower in the elderly group who are ineligible for intensive treatment. Survival and quality of life have been improved with the combination of the hypomethylating agent venetoclax HMA-V, which has become the standard of care for this group of patients. We aimed to evaluate the results of HMA-V combination therapy in the group of AML patients who are ineligible for intensive treatment at our centre. The median age of the 37 patients included in the study was 70.2 years, and 51.4 were women. 73 of the patients were de novo leukemia while 4 patients were relapse and 1 was refractory disease. The HMA-V combination was given 2 patients who were in remission due to intoleranceside effects of intensive treatment. Azacitidine usage rate was 78.6. The median number of course was 3. The remission rate was found to be 51.4 in bone marrow evaluation at the end of the 1st2nd course. The mean follow-up was 11.9 months and 56.75 of patients died. Mean survival was 27.1, 4.1 and 7.5 months for those who achieved remission, those who did not achieve remission and those who could not be assessed, respectively, with a significant difference between groups p 0.001. While mean and median survival with azacitidine were 22.03 and 23 months, with decitabine 3.87 and 3 months respectively, there was a significant statistical difference p0.001. In multivariate Cox regression analysis, the only factor influencing mortality was not being in remission at the end of 1st2nd cycle assessment. In conclusion, the survival and remission rates seen in our center are found to be similar to real-world studies.

 Ortanca tanı yaşı 68 olan akut myeloid lösemide AML intensif tedavi adayı olamayan ileri yaş grubunda sağkalım süresi belirgin olarak düşüktür. Günümüzde bu hasta grubu için standart tedavi haline gelen hipometilleyici ajan-venetoklaks HMA-V kombinasyonuyla sağkalım süresi ve yaşam kalitesi artmıştır. Biz de merkezimizde intensif tedaviye uygun olmayan AML hasta grubunda HMA-V kombinasyon tedavisi sonuçlarını incelemeyi amaçladık. Çalışmaya dahil edilen 37 hastanın ortanca yaşı 70.2 yıl ve 51.4 ü kadın idi. Hastaların 73ü de novo lösemi olup 4 hasta nüks, 1 hasta azasitidin sonrası refrakter hastalıktı. Remisyon sağlanan 2 hastaya intensif tedavi intoleransıyan etkisi nedeniyle HMA-V kombinasyonu verildi. Azasitidin kullanım oranı 78.6 idi. Ortanca kurs sayısı 3 idi. 1. veya 2. kurs sonunda kemik iliği değerlendirmesinde remisyon oranı 51.4 olarak bulundu. Ortalama izlem süresi 11.9 ay olup hastaların 56.75i hayatını kaybetti. Sağkalım analizlerinde ortalama ve ortanca yaşam süreleri 18 ve 13 ay olarak saptandı. Ortalama yaşam süreleri remisyon sağlananlarda, sağlanamayanlarda ve değerlendirilemeyenlerde sırasıyla 27.1, 4.1 ay ve ve 7.5 ay idi ve gruplar arasında anlamlı farklılık saptandı p 0.001. Azasitidin ile ortalama ve ortanca yaşam süreleri 22.03 ve 23 ay iken, desitabin ile bu süreler sırasıyla 3.87 ve 3 ay idi ve belirgin istatiksel farklılık mevcuttu p 0.001. Cox regresyon multivariate analizinde mortalite üzerinde etkili tek faktör 1.2. siklus sonu değerlendirmesinde remisyonda olmamak olarak bulundu p 0.004. Sonuç olarak, merkezimizin sağkalım ve remisyon oranları gerçek yaşam çalışmalarıyla benzer olarak bulunmuştur.

Article Details

Evaluation Of Hypomethylating Agent Venetoclax Combination In Patients With Acute Myeloid Leukaemia Ineligible For Intensive Treatment

Authors:

Tuğcan Alp Kırkızlar | Ahmet Muzaffer Demir

Publisher:

Eskişehir Osmangazi University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Osmangazi Tıp Dergisi Vol.46 Issue 2, pp.275-283

Document Type:

Article

Publication Date:

3/2024

Document Language:

Turkish

Document ID (Org No.):

2001306817

pISSN:

1305-4953

acute myeloid leukemia

azacitidine

decitabine

venetoclaxakut myeloid lösemi

azasitidin

desitabin

venetoklaks

Issues

Article Details

Authors: Tuğcan Alp Kırkızlar | Ahmet Muzaffer Demir

Publisher: Eskişehir Osmangazi University

Main Topics: Klinik Tıp Bilimleri (Diğer)

Journal: Osmangazi Tıp Dergisi Vol.46 Issue 2, pp.275-283

Document Type: Article

Publication Date: 3/2024

Document Language: Turkish

Document ID (Org No.): 2001306817

pISSN: 1305-4953

Issues

Authors:

Tuğcan Alp Kırkızlar | Ahmet Muzaffer Demir

Publisher:

Eskişehir Osmangazi University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Osmangazi Tıp Dergisi Vol.46 Issue 2, pp.275-283

Document Type:

Article

Publication Date:

3/2024

Document Language:

Turkish

Document ID (Org No.):

2001306817

pISSN:

1305-4953