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<p>In relapsed or refractory acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) cases, a curative approach is often possible with stem cell transplantation (SCT). In recent years, it has been suggested that the addition of the BCL-2 inhibitor venetoclax to conventional chemotherapy may improve treatment responses. In this study, we aimed to evaluate the effect of adding venetoclax on survival and remission responses. In this retrospective, single-center study, the data of a total of 49 patients diagnosed with relapsed or refractory AML or ALL who received salvage therapy before stem cell transplantation between 2020 and 2024 were obtained from the hospital information management system and analyzed retrospectively. Clinical outcomes of 27 patients treated with FLAG-IDA(fludarabine, high-dose cytarabine, idarubicin and G-CSF) and 22 patients treated with FLAG-IDA + venetoclax were compared. The rate of remission was found to be significantly higher in the group for whom venetoclax was added (<i>p</i> = 0.002). The time to mean remission was observed to be shorter in the venetoclax group. Overall survival was longer in the group receiving venetoclax, but was not statistically significant (<i>p</i> = 0.127). A significant trend in favor of venetoclax was also observed in stem cell transplantation rates (81.8% vs. 37.0%). Adding venetoclax to the FLAG-IDA regimen provides clinical benefits such as higher remission rates in relapsed/refractory AML and ALL patients and achieving remission in a shorter period of time.</p>

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FLAG-IDA With Or Without Venetoclax in Patients with Relapsed/Refractory Acute Leukemia: A Single Center Experience

  • 期刊论文

  • 发表日期：

    2026年3月24日

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  • Vehbi Demircan,
  • Songül Beskisiz Dönen,
  • Abdullah Karakuş,
  • Mehmet Orhan Ayyıldız

摘要

In relapsed or refractory acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) cases, a curative approach is often possible with stem cell transplantation (SCT). In recent years, it has been suggested that the addition of the BCL-2 inhibitor venetoclax to conventional chemotherapy may improve treatment responses. In this study, we aimed to evaluate the effect of adding venetoclax on survival and remission responses. In this retrospective, single-center study, the data of a total of 49 patients diagnosed with relapsed or refractory AML or ALL who received salvage therapy before stem cell transplantation between 2020 and 2024 were obtained from the hospital information management system and analyzed retrospectively. Clinical outcomes of 27 patients treated with FLAG-IDA(fludarabine, high-dose cytarabine, idarubicin and G-CSF) and 22 patients treated with FLAG-IDA + venetoclax were compared. The rate of remission was found to be significantly higher in the group for whom venetoclax was added (p = 0.002). The time to mean remission was observed to be shorter in the venetoclax group. Overall survival was longer in the group receiving venetoclax, but was not statistically significant (p = 0.127). A significant trend in favor of venetoclax was also observed in stem cell transplantation rates (81.8% vs. 37.0%). Adding venetoclax to the FLAG-IDA regimen provides clinical benefits such as higher remission rates in relapsed/refractory AML and ALL patients and achieving remission in a shorter period of time.