The use of venetoclax-based salvage therapy for post-hematopoietic cell transplantation relapse of acute myeloid leukemia.

Autor:	Byrne M; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Danielson N; Tennessee Valley Healthcare System, Nashville, Tennessee, USA., Sengsayadeth S; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Tennessee Valley Healthcare System, Nashville, Tennessee, USA., Rasche A; Department of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Culos K; Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Gatwood K; Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Wyatt H; Department of Pharmacy, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Chinratanalab W; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Tennessee Valley Healthcare System, Nashville, Tennessee, USA., Dholaria B; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Ferrell PB; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Fogo K; Department of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Goodman S; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Tennessee Valley Healthcare System, Nashville, Tennessee, USA., Jagasia M; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Jayani R; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Kassim A; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Mohan SR; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Savani BN; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Strickland SA; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Engelhardt BG; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA., Savona M; Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.; Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA.; Program in Cancer Biology, Vanderbilt University, Nashville, Tennessee, USA.
Jazyk:	angličtina
Zdroj:	American journal of hematology [Am J Hematol] 2020 Sep; Vol. 95 (9), pp. 1006-1014. Date of Electronic Publication: 2020 Jun 15.
DOI:	10.1002/ajh.25859
Abstrakt:	For patients with high risk myeloid disease, allogeneic hematopoietic cell transplantation (HCT) is the only potentially curative therapy. Unfortunately, many of these patients relapse after HCT and have a limited survival. The recent approval of venetoclax, an orally bioavailable BCL-2 inhibitor, resulted in significant responses in treatment naïve acute myeloid leukemia (AML), and off-label use in the relapsed/refractory setting is increasing. We report the outcomes of 21 patients who underwent allogeneic HCT for myeloid disease, relapsed with AML, and were treated with venetoclax. Several patients had poor risk features including antecedent hematologic malignancy (6/21), complex karyotype (6/21), and TP53 mutations (5/21). The median age was 64.5 years and time from HCT to relapse was 5.7 months (range: 0.9 to 44.9 months). Of the 19 patients who were assessed for response, there were meaningful treatment responses seen in eight patients: five CR, three CRi, zero PR, for an ORR of 42.1%. Treatment effect was seen in six additional patients, including four in the morphologic leukemia-free state. Nine patients maintained their response for ≥3 months and eight were receiving therapy at data cut. Post-HCT AML relapse has an exceedingly poor outcome, and venetoclax-based therapy is a potent therapy option that should be studied prospectively in this setting. (© 2020 Wiley Periodicals LLC.)
Databáze:	MEDLINE
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