Venetoclax-based salvage therapy as a bridge to transplant is feasible and effective in patients with relapsed/refractory AML.
Unglaub JM, Schlenk RF, Middeke JM, Krause S, Kraus S, Einsele H, Kramer M, Zukunft S, Kauer J, Renders S, Katelari E, Schliemann C, Pabst C, Luft T, Dreger P, Röllig C, Bornhäuser M, Müller-Tidow C, Sauer T (2025)
Publication Type: Journal article
Publication year: 2025
Journal
Book Volume: 9
Pages Range: 375-385
Journal Issue: 2
DOI: 10.1182/bloodadvances.2024013086
Abstract
The B-cell lymphoma 2 inhibitor venetoclax (VEN) in combination with hypomethylating agents has been approved for first-line treatment of patients with acute myeloid leukemia (AML) ineligible for intensive treatment. VEN-containing treatment strategies may also be effective in relapsed/refractory (R/R) AML; however, comparative studies with conventional therapies for fit patients as a bridge-to-transplant strategy are limited. Using propensity score matching (PSM), we compared 37 patients with R/R AML, who received VEN-based salvage therapy as bridge to allogeneic hematopoietic stem cell transplantation (allo-HCT), with 90 patients from the German Study Alliance Leukemia AML registry, who were treated with non-VEN-containing salvage therapy according to their treating physician's choice (TPC). The overall response rate among VEN patients was higher than the TPC control cohort (62% vs 42%; P = .049). Overall, 73% of VEN-treated patients vs 63% of TPC patients were bridged to allo-HCT (P = .41). After a median follow-up of 34.3 months for the VEN and 21.0 months for the TPC cohort, the median overall survival (OS) were 15.8 months (95% confidence interval [CI], 10.6 to not evaluable) and 10.5 months (95% CI, 6.8-19.6; P = .15), respectively. PSM revealed a trend toward improved OS for VEN patients (hazard ratio, 0.70; 95% CI, 0.41-1.22; P = .20). Median event-free survival was significantly longer in the VEN cohort (8.0 months) than the TPC cohort (3.7 months; P = .006). Our data suggest that VEN-based salvage therapy is a safe and effective bridge to allo-HCT for this difficult-to-treat AML patient population.
Authors with CRIS profile
Involved external institutions
Universitätsklinikum Heidelberg
Germany (DE)
Universitätsklinikum Carl Gustav Carus Dresden
Germany (DE)
Universitätsklinikum Münster
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Germany (DE)
Universitätsklinikum Carl Gustav Carus Dresden
Germany (DE)
Universitätsklinikum Münster
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
How to cite
APA:
Unglaub, J.M., Schlenk, R.F., Middeke, J.M., Krause, S., Kraus, S., Einsele, H.,... Sauer, T. (2025). Venetoclax-based salvage therapy as a bridge to transplant is feasible and effective in patients with relapsed/refractory AML. Blood Advances, 9(2), 375-385. https://doi.org/10.1182/bloodadvances.2024013086
MLA:
Unglaub, Julia M., et al. "Venetoclax-based salvage therapy as a bridge to transplant is feasible and effective in patients with relapsed/refractory AML." Blood Advances 9.2 (2025): 375-385.
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