Combination of Liposomal Mitoxantrone, Venetoclax, Homoharringtonine, and Olverembatinib (HQP1351) (MVHO) in Pediatric Patients with Refractory or Relapsed Acute Myeloid Leukemia (AML): Case Series
Abstract
Introduction: AML accounts for up to 25% of all pediatric acute leukemias. Although overall survival (OS) in pediatric AML has increased to 70% in recent years because of enhanced risk stratified intensive chemotherapy and hematopoietic stem cell transplantation. Unfortunately, more than 30% of patients experience relapse. Further increase intensity of chemotherapy was proven unfeasible for the toxicity and treatment related mortality. Hence, specific targeted therapy has been being explored to treat pediatric AML in recent decade. Because of the heterogeneity of AML and multiple pathways involved in leukemogenesis, single agent targeting one pathway was effective in limited cases. In this study, we designed a regimen to block multiple pathways with combination of Liposomal Mitoxantrone, Venetoclax, Homoharringtonine, and Olverembatinib (MVHO) to investigate its efficacy and safety in treatment of refractory or relapsed AML.
Methods: We enrolled patients with relapsed or newly diagnosed AML with poor prognosis with adverse molecular abnormalities, such as NUP98 rearrangements, FUS::ERG, CBFA2T3::GLIS2, and del7/7q, who did not achieve complete remission (CR) after first-line chemotherapy. Patients were administered the MVHO regimen, which included 1 dose of liposome mitoxantrone 8mg/m 2; venetoclax, 300 to 350mg/m 2 once daily, from day1 to day 7, (dose escalation for up to 3days from 50mg/m 2 if high tumor burden occur); homoharringtonine 2mg/m 2 once daily, from day1 to…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 18 participants or records.
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