Abstract

Background: Venetoclax, in combination with a hypomethylating agent or low-dose cytarabine, is approved for the treatment of acute myeloid leukemia (AML) in elderly patients or in those who are ineligible for intensive chemotherapy. The aim of our study was to investigate whether the venetoclax-containing regimen improved the survival of elderly AML patients in Taiwan.

Patients and methods: Thirty-two elderly patients (≥ 60 years) diagnosed with AML at our hospital from January 2018 to October 2022 were retrospectively enrolled. Clinical characteristics and molecular profiles of the patients were captured by chart review. All statistical analyses were calculated by using MedCalc Statistical Software.

Results: The median overall survival (OS) of our entire cohort was 4.0 months (95% confidence interval, 1.13-33.3 months). Patients receiving venetoclax-containing regimens or the best available therapy (BAT) had median OS of 33.3 months and 1.5 months, respectively (p < 0.001). The response rate of the venetoclax-containing regimen was 68.8% (11/16). Three patients treated with venetoclax underwent allogeneic peripheral blood stem cell transplantation and remained in remission at the last follow-up. Patients aged 75 years or older who were treated with venetoclax-containing regimens had better survival when compared to those who received BAT (11.3 months vs. 0.4 months, p = 0.018). Multivariate analysis showed that elderly AML patients aged 75 years or younger and those receiving venetoclaxcontaining regimens were 2 independent good prognostic factors for OS.

Conclusion: Venetoclax-based regimens prolonged the survival of elderly AML patients in Taiwan, even in those aged 75 years or older.