Abstract:
Combined therapy with venetoclax and hypomethylating agents has significantly improved the outcome of unfit patients ineligible for intensive chemotherapy. A recently published exploratory analysis of the VIALE-A trial reported that up to 51% of patients achieving remission survived more than 2 years. These data along with those from reallife settings, lead to questioning how long it is appropriate to continue treatment in long-term survivors. Accordingly, recent retrospective studies suggested the feasibility of suspending therapy in selected patients while maintaining prolonged responses. Also, these studies showed that retreatment may induce a second remission in almost a third of patients. We report the case of a patient who received salvage therapy with venetoclax and azacytidine, that was discontinued few cycles after blasts clearance because of severe hematological toxicity. Despite suspension, he maintained a sustained response lasting almost one year and was successfully retreated with the same combination when a second relapse occurred.
摘要:
维奈托克和低甲基化药物的联合治疗显着改善了不适合接受强化化疗的患者的预后。最近发表的对VIALE-A试验的探索性分析报告说,达到缓解的患者中有高达51%的患者存活超过2年。这些数据以及来自现实生活中的数据,导致质疑在长期幸存者中继续治疗多长时间是合适的。因此,最近的回顾性研究表明,在部分患者中暂停治疗,同时维持长期反应的可行性。此外,这些研究表明,再治疗可能会导致近三分之一的患者第二次缓解。我们报告了一例接受维奈托克和氮杂胞苷抢救治疗的患者,由于严重的血液学毒性,在母细胞清除后停止了几个周期。尽管暂停,他保持了持续近一年的持续反应,并在第二次复发时使用相同的组合成功治疗。