Venetoclax-based combinations in AML and high-risk MDS prior to and following allogeneic hematopoietic cell transplant
Jan Philipp Bewersdorf, Andriy Derkach, Lohith Gowda, Kamal Menghrajani, Susan DeWolf, Josel D. Ruiz, Doris M. Ponce, Brian C. Shaffer, Roni Tamari, James W. Young, Ann A. Jakubowski, Boglarka Gyurkocza, Alexander Chan, Wenbin Xiao, Jacob L. Glass, Amber C. King, Sheng F. Cai, Anthony F. Daniyan, Christopher Famulare, Bernadette M. Cuello, Nikolai A. Podoltsev, Mikhail Roshal, Sergio Giralt, Miguel‐Angel Perales, Stuart Seropian, Christina Cho, Amer M. Zeidan, Thomas Prébet, Eytan M. Stein, Martin S. Tallman, Aaron D. Goldberg, Maximilian Stahl
Abstract
The role of allogeneic hematopoietic cell transplant (allo-HCT) as consolidation after initial venetoclax therapy and the efficacy of venetoclax salvage therapy for relapse after allo-HCT in patients with acute myeloid leukemia (AML) are unclear. We conducted a retrospective study of patients with AML or myelodysplastic syndrome (MDS) who received venetoclax either before or after allo-HCT at Memorial Sloan Kettering Cancer Center and Yale University from 11 August 2016 to 16 November 2020. Among 39 heavily pretreated patients who received venetoclax before allo-HCT, median OS from allo-HCT was not reached after a median follow up of 12.5 months resulting in a 12-month OS estimate of 79.0%. In 37 patients who had received venetoclax-based combinations as salvage therapy after allo-HCT, the overall response rate was 32% with a median OS of 4.7 months (12-month OS estimate: 43.4%). Four patients underwent a second allo-HCT following venetoclax-based salvage therapy suggesting it as a potential salvage treatment option.