Procedures
aplastic, neutropenia, thrombocytopenia, MRD, intolerable adverse events, Cancer
ADVERSE EVENT, NEUTROPENIA, ADVERSE EVENT, THROMBOCYTOPENIA, RESIDUAL DISEASE, CANCER
VAH regimen consisted of 14-day courses of venetoclax and 7-day courses of azacitidine and homoharringtonine. Venetoclax began at 100 mg on day 1 and increased stepwise over 3 days to reach the target dose of 400 mg (100, 200, and 400 mg); dosing was continued at 400 mg per day from day 4 through day 14; azacitidine (75 mg/mCriteria for removing patients from trial treatment included the development of intolerable adverse events related to study treatment, patient withdrew informed consent, and completion of the protocol therapy and evaluation period. The cytogenetic evaluation was used with standard metaphase karyotype and fluorescence in situ hybridization analysis. Molecular analysis via polymerase chain reaction and 167-gene institutional next-generation sequencing platform was performed at study enrollment. Measurable residual disease (MRD) was assessed by 8-color multiparameter flow cytometry (FC) using leukemia-associated immunophenotype or different from normal assessment with a minimum sensitivity of 10For response assessments, BM was evaluated at cycle 1 day 28 and again 1–2 weeks after hematologic recovery if on day 28 BM was aplastic. Subsequent BM evaluations were done before and after cycle 2 and then, as clinically needed. Morphologic, cytogenetic, and MRD assessments were done during each BM assessment. Response criteria were defined by the European LeukemiaNet (ELN) 2017 guidelines. CR was defined as an absolute neutrophil count of more than 1000 cells per cubic millimeter, a platelet count of more than 100,000 per cubic millimeter, red-cell transfusion independence, and BM with less than 5% blasts. CRi was defined as all the criteria for CR, except for neutropenia (absolute neutrophil count, ≤ 1000 per cubic millimeter) or thrombocytopenia (platelet count, ≤ 100,000 per cubic millimeter) [Adverse events were defined as those that occurred from the first dose until 28 days after the discontinuation of treatment and were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 [