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Vol. 46. Núm. S4.
HEMO 2024
Páginas S391 (outubro 2024)
Vol. 46. Núm. S4.
HEMO 2024
Páginas S391 (outubro 2024)
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CLINICAL CHARACTERISTICS AND OUTCOME OF PATIENTS RECEIVING VENETOCLAX-BASED REGIMENS IN BRAZIL: A REAL-WORLD STUDY
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A Costaa, RLR Baptistab,c, M Guaranád,e, MPQ Netof, AA Johanng, VA Mauadh, C Chiattonei, E Fagundesj, FB Duartek, E Nunesl, M Dibaim, M Nuccin,o
a Department of Hematology, Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil
b Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
c Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
d Hospital Universitário Gaffrée e Guinle (HUGG), Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
e Hospital São Lucas, DASA, Rio de Janeiro, Brazil
f Hospital Nossa Senhora das Graças, Curitiba, Brazil
g Oncoclínicas Curitiba, Curitiba, Brazil
h Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
i Hospital Samaritano, São Paulo, Brazil
j Grupo Oncoclínicas, Belo Horizonte, Brazil
k Hospital Universitário Walter Cantídio (HUWC), Universidade Federal do Ceará (UFC), Fortaleza, Brazil
l Hospital de Clínicas da Universidade Federal do Paraná (UFPR), Curitiba, Brazil
m Hospital Samaritano, Rio de Janeiro, Brazil
n Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
o Grupo Oncoclínicas, Rio de Janeiro, Brazil
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Vol. 46. Núm S4

HEMO 2024

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Introduction

The combination of venetoclax with hypomethylating agents (VEM-HM) is considered standard of care for unfit or elderly patients with acute myeloid leukemia (AML). There are several real world studies describing complications and outcome of patients treated with venetoclax-based regimens, but none in Brazil.

Objective

To describe the clinical characteristics and outcome of patients with AML or MDS treated with venetoclax-based regimens in Brazil.

Methods

In this retrospective, multicentric study, we evaluated clinical characteristics and outcome of the first cycle of venetoclax-based regimens in the treatment of patients with AML and MDS.

Results

A total of 114 patients were analyzed, 71% were male and the median age was 66 years (range 19-95). Most of the patients had AML (91%) with high risk disease (61%) and 4.4% had MDS. The main indication for venetoclax use was unfit patient (60%) and the most common regimen used was VEN-HM (92 patients, 81%). Intensive chemotherapy was given in to patients. Almost all patients (94%) developed neutropenia during the first cycle and 27% did not recovery from neutropenia. Among patients receiving VEN-HM, 13% received quinolone prophylaxis and 6.5% received an anti-Aspergillus azole as prophylaxis. Febrile neutropenia occurred in 54% of patients and proven or probable invasive fungal disease (IFD) was diagnosed in 7%. At the end of the first cycle, 50% patients had complete response (CR) or complete response with incomplete hematologic recovery (CRi). Among patients receiving VEN-HM, CR + CRi was 58% in first line therapy and 38% in RR. The death rate after the first cycle was 8% and 67% received a second cycle.

Discussion

This is the first real world study in Brazil evaluating the use o venetoclax-based regimens in patients with AML and MDS. These results show that antibacterial and antimold prophylaxis was uncommon; yet, the rates of bacteremia and IFD was low. The 58% CR + CRi rate after the first cycle in patients receiving VEN-HMA in first line is similar to the rates observed in the randomized trial.

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Hematology, Transfusion and Cell Therapy
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