Transplant outcomes after intensive chemotherapy or venetoclax plus azacitidine in acute myeloid leukemia: a multicenter retrospective study in Japan

The present retrospective multicenter study in Japan evaluated the role of venetoclax plus azacitidine (V/A) before first allogeneic hematopoietic stem cell transplantation (SCT) in 144 transplant-eligible acute myeloid leukemia (AML). Thirty-seven patients received V/A prior to SCT, mainly as salvage therapy for refractory and adverse-risk AML. Patients were classified into four groups according to remission status at SCT and V/A use. The 1-year overall survival (OS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) of those who achieved complete remission (CR) with intensive chemotherapy (IC) were 93%, 5% and 4%, respectively. The 1-year OS, CIR and NRM of those who were refractory/intolerant to IC and achieved CR with V/A were 93%, 7% and 7%, respectively. The 1-year OS, CIR and NRM of those who were refractory to IC and proceeded directly to SCT were 52%, 54% and 13%, respectively. The 1-year OS, CIR and NRM of those who were refractory/intolerant to IC and refractory to V/A were 41%, 39% and 29%, respectively. Overall, use of V/A prior to SCT salvaged some AML patients who were refractory/intolerant to IC, and the transplant outcomes of these patients were favorable. Further studies are needed to optimize treatment for AML prior to SCT.

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Journal
Clinical Hematology International
Published
2026-09-22
DOI
https://doi.org/10.46989/001c.170281
Primary Topic
Acute Myeloid Leukemia Research
Type
article
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article

Transplant outcomes after intensive chemotherapy or venetoclax plus azacitidine in acute myeloid leukemia: a multicenter retrospective study in Japan

Daishi Nakagawa, Mitsumasa Watanabe, Katsuhiro Io, Kouhei Yamashita et al.
Clinical Hematology International
Acute Myeloid Leukemia Research
article

Transplant outcomes after intensive chemotherapy or venetoclax plus azacitidine in acute myeloid leukemia: a multicenter retrospective study in Japan

Daishi Nakagawa, Mitsumasa Watanabe, Katsuhiro Io, Kouhei Yamashita, Hiroki Amagase, Nobuyoshi Arima, Masakatsu Hishizawa, Kosuke Asagoe, Kazuhiro Yago, Kazunori Imada, Tomoharu Takeoka, 前田 健, Toshiyuki Kitano, Hiroyuki Muranushi, Ikue Okamura, Mutsumi Okada, Takehiro Okuda, Takashi Ikeda, Yasuko Miyahara, Tadakazu Kondo, Takashi Akasaka, Junya Kanda, Akifumi Takaori-Kondo, Satoko Oka, Yasuyuki Arai, Yasunori Ueda
article en

Abstract

The present retrospective multicenter study in Japan evaluated the role of venetoclax plus azacitidine (V/A) before first allogeneic hematopoietic stem cell transplantation (SCT) in 144 transplant-eligible acute myeloid leukemia (AML). Thirty-seven patients received V/A prior to SCT, mainly as salvage therapy for refractory and adverse-risk AML. Patients were classified into four groups according to remission status at SCT and V/A use. The 1-year overall survival (OS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) of those who achieved complete remission (CR) with intensive chemotherapy (IC) were 93%, 5% and 4%, respectively. The 1-year OS, CIR and NRM of those who were refractory/intolerant to IC and achieved CR with V/A were 93%, 7% and 7%, respectively. The 1-year OS, CIR and NRM of those who were refractory to IC and proceeded directly to SCT were 52%, 54% and 13%, respectively. The 1-year OS, CIR and NRM of those who were refractory/intolerant to IC and refractory to V/A were 41%, 39% and 29%, respectively. Overall, use of V/A prior to SCT salvaged some AML patients who were refractory/intolerant to IC, and the transplant outcomes of these patients were favorable. Further studies are needed to optimize treatment for AML prior to SCT.

Clinical Hematology InternationalVol. 8(3)
Kyoto University (JP), Tenri Hospital (JP), Shizuoka Cancer Center (JP), Kurashiki Central Hospital (JP), Kyoto City Hospital (JP), Kansai Electric Power Hospital (JP), Osaka Hospital (JP), Takatsuki Red Cross Hospital (JP), Otsu Red Cross Hospital (JP), Shizuoka General Hospital (JP), Hyogo Prefectural Amagasaki General Medical Center (JP), Shinko Hospital (JP), Kyoto Katsura Hospital (JP), Japanese Red Cross Society Wakayama Medical Center (JP), Shiga Medical Center (JP), Kitano Hospital (JP), Kobe City Medical Center General Hospital (JP)
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Openalex Percentile: Top 10%
Acute Myeloid Leukemia Research
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