[Observation of the Therapeutic Effect of Venetoclax Combined with HEA Regimen on Acute Myeloid Leukemia Patients with 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 gene rearrangement.

[METHODS] Six patients with AML accompanied by 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/(m·d) on day 1-7; Etoposide 100 mg/d on day 1-5; Cytarabine 100 mg/(m·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 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 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 gene rearrangement, with good safety. It may be a better choice for induction remission chemotherapy in newly diagnosed and relapsed/refractory AML patients with gene rearrangement.