HEMATOLOGIC RECOVERY FROM VENETOCLAX-CONTAINING LOW-INTENSITY REGIMENS
IN RELAPSED/REFRACTORY ACUTE MYELOID LEUKEMIA PATIENTS DEPENDING ON PRIOR
POSTER 41
ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION
Rabia Shahswar1, Gernot Beutel1, Piroska Klement1, Alina Rehberg1, Razif Gabdoulline1, Christian
Koenecke1, Dominik Markel1, Hendrik Eggers1, Matthias Eder1, Michael Stadler1, Lothar Hambach1,
Steve Ehrlich1, Gudrun Gohring2, Brigitte Schlegelberger2, Arne Trummer3, Jürgen Krauter3, Arnold
Ganser1, Felicitas Thol1 and Michael Heuser1
(1)Department of Hematology, Hemostaseology, Oncology and Stem Cell Transplantation, Hannover,
Germany
(2)Department of Human Genetics, Hannover Medical School, Hannover, Germany
(3)Department of Internal Medicine, Municipal Hospital Braunschweig, Braunschweig, Germany
Introduction: The combination treatment of venetoclax (VEN) with both low-dose cytarabine (LDAC)
and hypomethylating agents (HMA) in untreated primarily elderly AML patients yielded promising
response rates. Prolonged cytopenias are of potential concern in venetoclax treated patients,
especially in patients who underwent allogeneic hematopoietic cell transplantation (alloHCT) prior
venetoclax treatment.
Objective: To compare hematologic recovery in patients treated with VEN in combination with non-intensive
chemotherapy regimens for the treatment of relapsed or refractory (R/R) acute myeloid
leukemia (AML) depending on the pretreatment status for alloHCT.
Methods: In this retrospective controlled study (NCT03662724), we included patients aged 18 years
or older with R/R AML previously treated with VEN (days 1-14) combined with non-intensive
regimens, namely HMA or LDAC.
Responses were evaluated per revised International Working Group criteria for AML. Main outcome
measure was the rate of objective response (complete remission CR + CR with incomplete blood
count recovery CRi + partial remission PR + morphologic leukemia-free state). Safety and efficacy
analyses included all patients who received at least one cycle of VEN combination treatment. This
study was approved by the local Ethics Review Committee in accordance with the Declaration of
Helsinki.
Results: Between January 2017 and October 2019 47 patients with a median age of 66 years (range
27-80) received VEN with either HMA (n=43) or LDAC (n=4) and had safety and efficacy outcomes
reported. The patient cohort was a high-risk cohort of relapsed (n=24) and refractory (n=23) patients.
The analysis included 39 patients (62%) with secondary AML and 42 patients (89%) with intermediate
or poor risk AML according to ELN 2017 criteria. Seventeen patients (36%) had received prior
alloHCT. The ORR was 53% (n=25) with 20 complete responses (43%, CR/CRis), 2 MLFS (4%) and 3 PR
(6%). Three patients died before first assessment. Response rates were similar in patients with and
without prior alloHCT (ORR 53% vs. 53%). In responding patients the median time to neutrophil
(≥1.0x109/L) and platelet recovery (≥100x109/L) was 53 and 56 days, respectively. No differences in
recovery times were observed between patients with and without prior alloHCT (42 vs. 42 days for
neutrophil recovery (p=0.8); 56 vs. 28 days for platelet recovery (p=0.68)).
Conclusions: Venetoclax in combination with non-intensive regimens showed promising response
rates for treatment of relapsed or refractory AML with good tolerability and acceptable duration of
cytopenias with no differences in recovery times in patients with and without prior alloHCT.
SCIENTIFIC
PROGRAMME
RARE SUBSETS OF
ACUTE LEUKAEMIA
TRACKING LEUKAEMIC
STEM CELLS (LSCs)
ROUTINE DIAGNOSIS
GENE EXPRESSION
AND MUTATIONAL
PROFILING
DEBATE 1 – ALL
PATIENTS WITH
INTERMEDIATE-RISK
AML MUST BE
TRANSPLANTED
INTERACTIVE
CASES 1 – MUTATION-BASED
THERAPY
OFF-LABEL
ROUNDTABLE –
SHOULD WE REALLY
USE NEW TARGETED
INHIBITORS AS SINGLE
AGENTS ?
ADDITION OF A 3RD
AGENT TO FRONTLINE
7+3
ROUNDTABLE –
CURATIVE OPTIONS
FOR OLDER AML
INTERACTIVE CASES 2
DEBATE 2 - BEST
TREATMENT FOR
NPM1-MUTATED AML IN
THE NEXT FUTURE ?
ALLOGENEIC
HAEMATOPOIETIC
STEM CELL
TRANSPLANTATION
(HSCT)
IMMUNOTHERAPY FOR
ACUTE LEUKAEMIA
DEBATE 3 - T-ALL:
WHERE ARE WE GOING
NOW?
SELECTED ABSTRACTS
AND CLINICAL
CASES FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES