Practical experience with the treatment of elderly patients with acute myeloblastic leukaemia with the combination of azacitidine and venetoclax

Purpose: AML patients unfit for intensive treatment were referred for symptomatic and palliative treatment until 2019. Many times, elderly AML patients over the age of 70 were not referred to hematology centers because we simply did not have drugs with the potential to induce disease remission. The situation changed dramatically with the advent of venetoclax, a Bcl-2 inhibitor. Case: With the new treatment, we had to learn how to manage the complications that an azacitidine with venetoclax regimen brings. Using 2 case reports as examples, we explained the risk of tumor lysis syndrom and the risk of long aplasia associated with infectious complications. Conclusion: Based on our experience, we offered insights into our internal recommendations. We used an abbreviated regimen: 7 days of azacitidine and 14 days of venetoclax, early bone marrow examination, administering growth factors in the cases of proven remission, and posaconazole during the period of severe neutropenia. (author)