RISK FACTORS FOR INFECTIOUS ADVERSE EVENTS IN NEWLY DIAGNOSED ACUTE
MYELOID LEUKEMIA PATIENTS TREATED WITH VENETOCLAX COMBINATIONS: A
RETROSPECTIVE SINGLE-CENTRE REAL-WORLD EXPERIENCE
Abstract
Background: Venetoclax-based (ven) combinations have become a
standard of care for acute myeloid leukemia (AML) patients ineligible
for intensive chemotherapy. However, the associated risk of infectious
adverse events (IAEs) remains a significant clinical concern.
Aims: This study aimed to evaluate the incidence,
characteristics, and risk factors for IAEs in newly diagnosed AML
patients treated with venetoclax combinations in a real-world setting.
Methods and Results: We conducted a retrospective cohort study
of AML patients treated with ven in combination with hypomethylating
agents or low-dose cytarabine (LDAC), with analyses performed on a
treatment cycle basis. Clinical and laboratory data, including IAE
characteristics, duration of neutropenia, and concomitant medications,
were collected, and grade ≥2 IAEs were included according to CTCAE v5.0
criteria. The cohort included 143 treatment cycles of 43 patients, with
a median neutropenia duration of 13 days (5–35). A total of 34 (23.8%)
grade ≥2 IAEs occurred, with an incidence of 1 per 121 patient-days.
Multivariate analysis identified prolonged neutropenia (days, OR=1.037,
p=0.005) and interacting concomitant medications (OR=9.99,
p<0.001) as independent risk factors for IAEs. The rate of
invasive fungal infections was as low as 3.5%, and the use of
antifungal or antibacterial prophylaxis was not associated with a
reduction in the rate of IAEs. Conclusion: IAEs remain a
substantial risk in venetoclax-treated AML patients, particularly during
prolonged neutropenia and with concomitant drug interactions. Optimizing
venetoclax regimens and careful management of interacting medications
may mitigate these risks.