Chidamide combined with decitabine, venetoclax, and low-dose cytarabine for relapsed/refractory acute myeloid leukemia: a single-center case series

Relapsed/refractory acute myeloid leukemia (R/R AML) carries a poor prognosis. We report three patients with R/R AML, each of whom had relapsed after at least two prior chemotherapy regimens or hematopoietic stem-cell transplantation (HSCT), treated with chidamide, decitabine, venetoclax, and low-dose cytarabine (LDAC) (CHI-DEC-VEN-LDAC). After a single treatment cycle, all three patients achieved complete remission (CR), and two attained minimal residual disease (MRD) negativity. Adverse events were manageable, primarily consisting of cytopenias and infections, with no treatment-related deaths. These results suggest that the therapy is effective and well-tolerated, particularly in patients with R/R AML who have had extensive prior treatment. The regimen shows promise as a potential bridging or debulking strategy, but further research with larger cohorts and longer follow-up is needed to confirm its long-term efficacy. These cases highlight the potential benefits of chemotherapy-free or low-chemotherapy approaches for R/R AML treatment.