ArticleJournal of hematology2026
The Impact of Induction With Azacitidine and Venetoclax Versus Intensive Chemotherapy on Outcomes After Allogeneic Hematopoietic Cell Transplantation for Newly Diagnosed Acute Myeloid Leukemia.
Article in Journal of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Induction with azacitidine and venetoclax (AZA-VEN) is standard therapy for patients 75 years or older or those with comorbidities that preclude intensive chemotherapy (IC) for acute myeloid leukemia (AML). Data on the impact of AZA-VEN on allogeneic hematopoietic cell transplant (HCT) outcomes in younger, fit patients are limited. Methods: In a single-center retrospective study, we examined adult patients with newly diagnosed AML receiving either AZA-VEN or IC (cytarabine and anthracycline) to attain first complete remission (CR) before allogeneic HCT with posttransplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis between 2023 and 2025. Results: The median age in the AZA-VEN (N = 14) and IC (N = 17) groups was similar (67 years (62-69) vs. 63 years (54-66), P = 0.13). The AZA-VEN group had more adverse-risk AML (93% vs. 41%, P = 0.001). Otherwise, there were no significant differences in Hematopoietic Cell Transplantation Comorbidity Index, secondary AML incidence, minimal residual disease (MRD) status, or donor types between the two cohorts. The AZA-VEN and IC cohorts had similar 1-year overall survival (69.2%, 95% confidence interval (CI) (48.2-99.5) vs. 75%, 95% CI (56.5-99.7), P = 0.73), 1-year relapse-free survival (57.1%, 95% CI (36.3-89.9) vs. 64.7%, 95% CI (45.5-91.9), P = 0.67), 1-year GVHD-free relapse-free survival (57.1%, 95% CI (36.3-89.9) vs. 64.7% 95% CI (45.5-91.9), P = 0.67), 1-year cumulative incidence of relapse (14.3% vs. 11.8%, P = 0.84), 1-year cumulative incidence of non-relapse mortality (28.5% vs. 23.5%, P = 0.76), 1-year cumulative incidence of grade 3-4 acute GVHD (14.3% vs. 5.9%, P = 0.46), and 1-year cumulative incidence of chronic GVHD (7.1% vs. 11.8 %, P = 0.67). On multivariable Cox analysis, there was no significant impact of treatment cohort (AZA-VEN vs. IC), MRD, adverse-risk genetics, acute GVHD, Hematopoietic Cell Transplantation Comorbidity Index, or age on overall survival. Conclusions: In newly diagnosed AML, AZA-VEN and IC induction yield comparable outcomes after allogeneic HCT, regardless of age or adverse genetics, warranting prospective studies.
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