[Observation of the Therapeutic Effect of Venetoclax Combined with HEA Regimen on Acute Myeloid Leukemia Patients with KMT2A Gene Rearrangement].

OBJECTIVE

To observe the treatment response rate and safety of the combination of venetoclax and HEA (VHEA) regimen in the induction therapy of acute myeloid leukemia (AML) patients with KMT2A gene rearrangement.

METHODS

Six patients with AML accompanied by KMT2A gene rearrangement were treated with the VHEA regimen ［venetoclax 100 mg on day 1, 200 mg on day 2, 400 mg on day 3-14; Homoharringtonine 2 mg/(m2·d) on day 1-7; Etoposide 100 mg/d on day 1-5; Cytarabine 100 mg/(m2·d) on day 1-7］. The remission rate and safety of the VHEA regimen were observed.

RESULTS

Among the 6 patients, 3 were relapsed or refractory AML, and 3 were newly diagnosed patients. After one course of induction chemotherapy, 5 patients achieved complete remission (CR), with 3 cases showing minimal residual disease (MRD) < 1.0×10-3 by flow cytometry and 3 cases showing 0.00% MRD by PCR, one patient who relapsed 13 months after transplantation died from pulmonary infection before evaluating the efficacy. Three patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CR1, one patient relapsed 12 months after transplantation, with a total survival time of 20 months. The other 2 patients are currently in disease-free survival, with a follow-up period of 15 months and 5 months, respectively. Two patients did not undergo allo-HSCT, one patient died from relapse 4 months after survival, and the other patient is currently in CR and undergoing maintenance chemotherapy. The total CR rate of VHEA regimen in 6 patients with KMT2A gene rearrangement AML was 83.3% (5/6), with no treatment-related deaths. Chemotherapy-related adverse reactions such as myelosuppression and infection were within controllable range.

CONCLUSION

The VHEA regimen can significantly improve the CR rate of AML patients with KMT2A gene rearrangement, with good safety. It may be a better choice for induction remission chemotherapy in newly diagnosed and relapsed/refractory AML patients with KMT2A gene rearrangement.