Venetoclax and Azacitidine in Relapsed/Refractory Acute Myeloid Leukemia and High Risk Myelodysplastic Syndrome: Bursa Uludag University Experience

Abstract

The management of acute myeloid leukemia (AML) gradually turns into an individualized approach with the application of targeted therapies. Venetoclax is a BCL-2 inhibitor that is synergistic with azacitidine. In this case series, 14 patients diagnosed with relapsed / refractory AML and 1 MDS RAEB-1 were followed up with venetoclax + azacitidine in the Hematology Department Bursa Uludag University Faculty of Medicine were evaluated. The best responses obtained with venetoclax + azacitidine were complete remission (CR) in one patient, complete remission with incomplete hematologic recovery (CRi) in one patient, morphological leukemia-free state (MLFS) in 4 patients, and partial response (PR) in one patient. The median time to first response with treatment was one month (0.5-5). The time to enter early remission is critical. For this reason, deaths due to infection should be prevented. Although the toxicities of this combination therapy can be managed, close follow-up of the patients is mandatory. In conclusion, this combination therapy is promising as it is relatively well-tolerated, improves the quality of life, and prolongs survival.