How do you manage persistent cytopenias in patients with AML who achieve a complete remission with incomplete count recovery after venetoclax and HMA?

Topics: Medical Oncology • Leukemia • AML

(i.e. CRi)

Answer from: Medical Oncologist at Academic Institution

This is an important question. How to manage cytopenias on HMA + venetoclax-based regimens is one of the biggest conundrums in the management of AML. The clinical trials to date have not uniformly answered this question based on level 1 evidence. These recommendations are mainly based on anecdotal d...

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Medical Oncologist at The Christ Hospital Network
Great Answer. We are doing a similar practice.

Answer from: Medical Oncologist at Academic Institution

This is a challenging and frequent question regarding the upfront use of venetoclax and hypomethylating agents in older individuals. Our practice is as outlined by @Joshua F. Zeidner, except that we perform a bone marrow biopsy on day 21 of first cycle of therapy. If there is evidence of cytoreducti...

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Medical Oncologist at The Christ Hospital Network
Some hematologists are careful with giving Neupoge...

Medical Oncologist at Roswell Park Cancer Center
I agree. Neupogen is only given after bone marrow ...

Medical Oncologist at UNC Lineberger Comprehensive Cancer Center
Agreed. I take an even more conservative approach ...

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