Management guide for treatment with venetoclax and azacitidine in patients with acute myeloid leukemia ineligible for intensive chemotherapy
- 2025, Volume 44 - Number 1
- Published: July 16, 2025
Management guide for treatment with venetoclax and azacitidine in patients with acute myeloid leukemia ineligible for intensive chemotherapy
Ferran Vall-llovera 1, Mar Tormo 2, Montserrat Arnan 3, Joan Bargay 4, Marta Cervera 5, Marina Díaz-Beyá 6, María A. Sampol 7, Antoni García 8, Sara García 9, Marta Gómez 10, Cristina Motlló 10, Guadalupe Oñate 11, Olga Salamero 12, Jordi Esteve 6, Susana Vives 13
1 Servei d’Hematologia, Hospital Universitari Mútua de Terrassa, Terrassa, España; 2 Servicio de Hematología, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia, España; 3 Servei d’Hematologia, Institut Català d’Oncologia, Hospital Duran i Reynals, Barcelona, España; 4 Servei d’Hematologia, Hospital Universitari Son LLàtzer, Palma de Mallorca, Mallorca, España; 5 Servei d’Hematologia, Hospital Universitari Joan XXIII, Tarragona, España; 6 Servei d’Hematologia, Hospital Clínic i Provincial de Barcelona, Barcelona, España; 7 Servei d’Hematologia, Hospital Universitari Son Espases, Palma de Mallorca, Mallorca, España; 8 Servei d’Hematologia, Hospital Universitari Arnau de Vilanova, Lleida, España; 9 Servei d’Hematologia, Hospital del Mar-Parc de Salut MAR, Barcelona, España; 10 Servei d’Hematologia, Corporació Sanitària Parc Taulí de Sabadell, Sabadell, Barcelona, España; 11 Servei d’Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, España; 12 Servei d’Hematologia, Hospital Universitari Vall d’Hebron, Barcelona, España; 13 Servei d’Hematologia, Hospital Universitari Germans Trias i Pujol-ICO Badalona, Institut de Recerca Josep Carreras, Badalona, Barcelona. España
Ferran Vall-llovera, Mar Tormo, Montserrat Arnan, Joan Bargay, Marta Cervera, Marina Díaz-Beyá, María A. Sampol, Antoni García, Sara García, Marta Gómez, Cristina Motlló, Guadalupe Oñate, Olga Salamero, Jordi Esteve, Susana Vives
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Antoni García, Email not available
Summary
Acute myeloid leukemia (AML) is a disease with poor prognosis, characterized by significant clinical and biological heterogeneity. Although the genetic diversity of AML has been recognized for over 30 years, recent advancements in gene sequencing have uncovered its complex molecular landscape, identifying clinical mechanisms and recurrently implicated genes driving its pathogenesis. This enhanced understanding has facilitated the development of risk-adapted therapies, which, combined with improvements in supportive care and hematopoietic stem cell transplantation (SCT), have increased the cure rates to approximately 50% in younger patients. However, this progress has not been mirrored in older patients or those with comorbidities, who are ineligible for intensive chemotherapy or SCT. In recent years, the VIALE clinical trials, which evaluate the combination of venetoclax with low-dose cytarabine or azacitidine, have demonstrated promising outcomes. Notably, the VIALE-A phase III trial demonstrated that combined venetoclax with azacitidine significantly improved overall survival, with a median of 14.7 months compared to 9.6 months observed with azacitidine as single agent. These findings have changed the therapeutic approach for these patients, leading the CETLAM (Grupo Cooperativo de Estudio y Tratamiento de las Leucemias Agudas y Mielodisplasias) group to develop a consensus guideline for their management.
Keywords: Acute myeloid leukemia. Venetoclax. Azacitidine. CETLAM.
