Impact of delayed venetoclax-based treatment on overall survival in newly diagnosed AML

Baden et al. published an article in Haematologica, assessing the impact on overall survival of time from diagnosis to treatment initiation in patients with acute myeloid leukemia (AML) receiving venetoclax-based combination therapies. Real-world data from the Study Alliance Leukemia (SAL) registry (n = 138) and the global healthcare network TriNetX (n = 717) were analyzed retrospectively.

Median overall survival in patients receiving treatment within the first 9 days of diagnosis (early) vs those receiving treatment on or after Day 10 (later) was:

• 7.7 vs 9.6 months, respectively, in the SAL registry (p = 0.42); and
• 7.5 vs 7.2 months, respectively, in the TriNetX network (p = 0.41).

Overall survival after 12 months was similar between patients receiving early and later treatment, and this was maintained in patients aged ≥75 years and in those with leukocytes ≥20 × 10⁹/L.

There were no significant differences in treatment safety, event-free survival, and relapse-free survival between patients receiving early vs later treatment.

The study suggests that a delay in venetoclax based treatment in newly diagnosed AML does not accumulate risk factors, affect treatment efficacy, or influence outcomes.

• Further, delaying treatment could potentially improve outcomes in specific subsets of the AML population, such as those with targetable lesions and reversible comorbidities.