Efficacy and prognosis of venetoclax combined with the 3+7 regimen in fit AML: A propensity score-matched cohort study

Abstract Objective: To compare the efficacy and survival outcomes between the standard “3+7” regimen and the “3+7” regimen combined with venetoclax in fit acute myeloid leukemia (AML) patients. Methods: This retrospective study enrolled 90 fit AML patients who received the standard “3+7” induction therapy at the Sichuan Provincial People's Hospital between January 2019 and December 2021, and 128 fit AML patients who received the “3+7” regimen combined with venetoclax between January 2022 and May 2024. A 1:1 propensity score matching (PSM) analysis was performed using SPSS software to balance baseline characteristics between the groups. The primary endpoints, including composite complete remission rate (CRc), measurable residual disease (MRD)-negative rate, and overall survival (OS), were used to compare treatment efficacy and survival outcomes. Results: After PSM, 61 matched patients were included in each group, with well-balanced baseline characteristics. Compared to the standard “3+7” regimen group, the venetoclax-combined group demonstrated significantly superior efficacy and survival outcomes: a higher CRc rate (77.05% vs. 57.38%, P = 0.021) and significantly prolonged median OS (mOS: not reached vs. 49.6 months, Log-rank P < 0.01). Conclusion: In fit AML patients, the “3+7” regimen combined with venetoclax significantly improves the CRc rate and extends OS compared to the standard “3+7” regimen alone. These findings suggest that venetoclax combined with intensive chemotherapy may represent a superior induction therapy option for fit AML.