Significance of cycle 1 bone marrow biopsy in predicting outcomes and toxicities of venetoclax-based therapy for myeloid malignancies.

IF 2.2 4区 医学 Q3 HEMATOLOGY Leukemia & Lymphoma Pub Date : 2024-12-27 DOI:10.1080/10428194.2024.2444480
Jeffrey Baron, Daniel Appiah, Mark G Faber, Han Yu, Tara Cronin, Jared Vega, Samantha Poblete, Pamela J Sung, Elizabeth A Griffiths, Amanda Przespolewski, James E Thompson, Steven Green, Eunice S Wang
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Abstract

For older unfit patients receiving venetoclax-based induction, data on the significance of interim bone marrow biopies (BMBx) findings on clinical outcomes is lacking. We retrospectively evaluated interim BMBx results performed on Cycle 1 days 21-28 of venetoclax-based therapy in 69 adults with myeloid malignancies to determine whether blast clearance was associated with overall survival (OS) and overall response rate (ORR). Median age was 75 years (range 69-78). Results demonstrated blast reduction (BR, <5% blasts) in 71%. Venetoclax was held to allow count recovery in 86% of these patients. Achieving interim BMBx BR was significantly associated with OS (p = 0.0033) and ORR (Cohen's kappa 0.39). Patients whose venetoclax was held experienced low rates of infection and reduced cytopenias. These findings support the importance of cycle 1 BMBx assessment during venetoclax-based therapies, specifically in predicting which patients will achieve optimal outcomes and in mitigating toxicity.

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第1周期骨髓活检在预测髓系恶性肿瘤以维托克拉克斯为基础的治疗结果和毒性中的意义。
对于接受venetoclax为基础诱导的老年不适应患者,缺乏中期骨髓活检(BMBx)结果对临床结果的意义的数据。我们回顾性地评估了69例髓系恶性肿瘤患者接受venetoclax为基础的治疗的第1周期21-28天的中期BMBx结果,以确定细胞清除率是否与总生存期(OS)和总缓解率(ORR)相关。中位年龄为75岁(范围69-78岁)。结果显示,爆炸减少率(BR, p = 0.0033)和ORR (Cohen’s kappa 0.39)。使用venetoclax的患者感染率较低,减少了细胞减少。这些发现支持了第1周期BMBx评估在venetoclax为基础的治疗中的重要性,特别是在预测哪些患者将获得最佳结果和减轻毒性方面。
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来源期刊
Leukemia & Lymphoma
Leukemia & Lymphoma 医学-血液学
CiteScore
4.10
自引率
3.80%
发文量
384
审稿时长
1.8 months
期刊介绍: Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor
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