Efficacy of Venetoclax combined with Homoharringtonine and Cytarabine for Younger Adults with Newly Diagnosed AML

Venetoclax (VEN) based induction therapy have shown a promising treatment for patients with acute myeloid leukemia (AML). However, the optimal VEN combination is urgently needed. We aimed to investigate the effective and tolerability of venetoclax combined with homoharringtonine plus cytarabine (VHA) regimen for newly diagnosed AML. We retrospectively analyzed the outcomes of 55 ND AML patients treated with VHA regimen. The overall response rate (ORR) was 92.7% (51/55, 95% CI 82%-98%). The composite complete remission (CRc) rate was 87.3% (48/55, 95% CI 76%-95). 44 (91.7%, 95% CI 67-90) of 48 patients who reached complete remission (CR) and measurable residual disease (MRD)-negative was attained in 85.4% of CRc patients (41/48, 95% CI72-94). ORR and CRc were 95% (19 of 20 patients)[95% CI 75%-100%] and 75% (15 of 20 patients) [95% CI 51%-91%] in patients with adverse risk. The most common grade 3-4 adverse events were febrile neutropenia (32.7%), pneumonia (16.3%) and sepsis (9.1%). Median overall survival (OS) was 26 months and event-free survival (EFS) was not reached. 1-year overall survival was 83%, 1-year event-free survival was 82%. These preliminary data suggest that the VHA regimen leads to a very high rate of CR and low toxicity. Especially for adverse risk patients, it provide an opportunity for allogeneic haematopoietic stem cell transplantation (allo-HSCT).