[Efficacy and safety of venetoclax-cytarabine-homoharringtonine-based cytoreductive therapy before allogeneic hematopoietic stem cell transplantation in refractory/relapsed acute myeloid leukemia with RUNX1::RUNX1T1: a retrospective study].

Clinical data from five patients with refractory/relapsed acute myeloid leukemia (AML) and RUNX1::RUNX1T1 fusion gene, treated with venetoclax, cytarabine, and homoharringtonine-based cytoreductive therapy before allogeneic hematopoietic stem cell transplantation (allo-HSCT) at Ruijin Hospital between March 2023 and December 2024, were retrospectively reviewed. The median time from diagnosis to allo-HSCT was 315 days (range: 217-560) . All patients achieved full donor chimerism by day 30 post-allo-HSCT. Within 6 months after transplant, the RUNX1::RUNX1T1 fusion gene was undetectable in all patients, with a median time to negative conversion of 2 months (range: 1-6 months) . The median follow-up time was 625 days (range: 372-1 010) . All patients remained disease-free, with no events of measurable residual disease (MRD) positivity by flow cytometry or molecular analysis documented. These findings preliminarily confirm that venetoclax, cytarabine, and homoharringtonine-based cytoreductive therapy is a safe and effective bridging therapy for allo-HSCT in patients with refractory/relapsed AML and RUNX1::RUNX1T1 fusion gene.