摘要
Abstract
Objective:To evaluate the efficacy and safety of azacitidine(AZA)combined with venetoclax(VEN)in elderly patients with newly diagnosed acute myeloid leukemia(AML).Methods:A retrospective analysis was conducted on 41 elderly AML patients trea-ted at our hospital between May 2020 and December 2024.All patients received AZA+VEN therapy.The primary endpoint was the com-posite complete remission rate(CR/CRi),while secondary endpoints included overall response rate(ORR)and minimal residual disease(MRD)negativity.Univariate and multivariate analyses were performed to identify predictive factors.Results:After a median of 3 treat-ment cycles,the CR/CRi rate was 51.22％(21/41),and the ORR was 63.41％(26/41).In the first cycle treatment,43.90％achieved CR/CRi,and 61.90％patients attained MRD negativity within 1-2 cycles.Multivariate analysis identified age ≥75 years,baseline hemoglobin(Hb)≥80 g·L-1,ASXL1 mutation,and absence of TP53 mutation as independent predictors of response(P＜0.05).With a median follow-up of 10.6 months,the 1-year overall survival(OS)rate was 55.39％.Baseline blast count ≥50％,TP53 mutation,and failure to achieve CR/CRi significantly reduced survival(P＜0.05)and were independent adverse prognostic fac-tors.All patients experienced grade Ⅲ-Ⅳ hematologic toxicity,with pulmonary infections being the predominant non-hematologic toxici-ty.One infection-related death occurred.Conclusion:AZA plus VEN demonstrates significant efficacy and manageable safety in elderly newly diagnosed AML patients.Age,Hb level,and ASXL1/TP53 mutations can predict treatment response,while blast burden,TP53 aberrations,and remission status are key prognostic indicators.关键词
阿扎胞苷/维奈克拉/老年急性髓系白血病/首次治疗/治疗反应/生存预后/安全性分析Key words
Azacitidine/Venetoclax/Elderly acute myeloid leukemia/Newly diagnosed/Treatment response/Survival prognosis/Safety analysis分类
医药卫生
