Efficacy of Venetoclax Combined With Intensive Chemotherapy in Different Subgroups of AML

Patients will receive 1 course of intensive chemotherapy combined with venetoclax for induction and those who achieved complete remission will receive 3 courses of intermediate-dose cytarabine combined with Venetoclax for consolidation. After consolidation therapy, Venetoclax in combination with azacitidine will be applied for 6 courses as maintenance treatment. Allogeneic hematopoietic stem cell transplantation is recommended for high-risk groups and intermediate-risk with positive measurable residual disease.

Inclusion criteria

• Patients who meet AML according to WHO (2022) or AML and MDS/AML defined by ICC standards.
• Age ≥14 years old, ≤ 60 years old, male or female.
• The physical status assessment (ECOG-PS) of the Eastern Oncology Collaboration group was 0-2 points.
• Fulfill the requirements of the following laboratory tests (performed within 7 days prior to treatment) :

• Total bilirubin ≤ 1.5 times the upper limit of normal value (same age);
• AST and ALT≤ 2.5 times the upper limit of normal value (same age);
• Blood creatinine < 2 times the upper limit of normal (same age);
• Myocardial enzymes < 2 times the upper limit of normal (same age);
• Left ventricular ejection fraction &gt;50% by measure of echocardiogram (ECHO). Informed consent must be signed before the commencement of all specific study procedures, and signed by the patient himself or his immediate family. Considering the patient&#39;s condition, if the patient&#39;s signature is not conducive to the treatment of the condition, the informed consent shall be signed by the legal guardian or the patient&#39;s immediate family.

Exclusion criteria

Subjects who meet any of the following criteria are excluded from the study:

• Acute promyelocytic leukemia with PML-RARA fusion gene
• Acute myeloid leukemia with BCR-ABL fusion gene
• Treated patients (but can receive hydroxyurea or cytarabine to the lower tumor burden).
• Concurrent malignant tumors of other organs (those requiring treatment).
• Active heart disease, defined as one or more of the following:

• A history of uncontrolled or symptomatic angina;
• Myocardial infarction less than 6 months after enrollment;
• Have a history of arrhythmia requiring drug treatment or severe clinical symptoms;
• Uncontrolled or symptomatic congestive heart failure (> NYHA level 2);
• Serious infectious diseases (uncured tuberculosis, pulmonary aspergillosis).
• Those who were not considered suitable for inclusion by the researchers.