The following is a summary of “Efficacy of venetoclax combined with decitabine conditioning regimen for allogeneic hematopoietic stem cell transplantation in high-risk and elderly patients with myeloid neoplasms,” published in the October 2023 issue of Hematology by Zheng et al.
Researchers started a retrospective study to evaluate the addition of venetoclax and decitabine to conditioning for allogeneic hematopoietic stem cell transplantation in high-risk and elderly patients with myeloid neoplasms.
They enrolled 19 patients in the trial (December 2021 to February 2023) and observed their progress for a median follow-up duration of 258 days, which ranged from 35 to 544 days. In the initial regimen (n=11), venetoclax was given at a daily dose of 400 mg from day −14 to day −1, while in the modified regimen (n=8), it was administered from day −14 to day −5. Decitabine was orally administered at a dose of 20mg/m2 /day from day −7 to day −3.
The results showed grade 3/4 adverse events, hematological events, hypertension, infections, allergy, and increased amylase. The 6-month overall survival (OS) and relapse-free survival (RFS) rates were 63% (95% CI, 45–89) for both. The non-relapse mortality (NRM) rate at 6 months was 37% (95% CI, 16–58), while the cumulative incidence of relapse (CIR) was 0. The incidence of grade II-IV acute graft-versus-host disease (aGVHD) and grade III-IV aGVHD within 100 days was relatively high at 31% (95% CI, 12–53) and 26% (95% CI, 9–47), respectively. These findings indicate a higher risk in elderly patients, making this regimen less suitable for them.
They concluded that more high-quality studies are needed to improve conditioning regimens for high-risk and elderly myeloid neoplasms.