Infectious Complications and Antibiotic Prophylaxis during Induction Therapy with Venetoclax Plus Azacitidine for Previously Untreated AML: A Real-World Experience
Abstract
Venetoclax + azacitidine (ven-aza) induction therapy has become the standard of care at many centers for AML patients who are unfit for intensive induction therapy. Although widely utilized, the efficacy of antimicrobial prophylaxis during induction with this regimen has not been clearly determined. We retrospectively evaluated infectious complications during ven-aza induction therapy in all previously untreated AML patients receiving this regimen at the University of Alberta Hospital, Alberta, Canada from August 2020 - June 2024. There were 93 patients; the median age was 76 (range 58-90) years. ELN 2022 risk scores were: favorable 15, Intermediate 19, adverse 50, indeterminate 9; 30 had a prior myeloid malignancy or therapy-related AML. All patients received azacitidine 75 mg/m2 subcutaneously daily x7 plus venetoclax po daily x21-28 days, dose adjusted according to the azole antifungal used. Of these, 75 were managed on an outpatient basis after the venetoclax ramp-up phase; the remainder were hospitalized due to co-morbid medical issues. Use of antimicrobial prophylaxis was at the discretion of the treating physician. Outcomes were assessed only during the initial induction cycle, for a minimum 30 days, or up to day 60 if delayed neutrophil recovery occurred.
Antibacterial prophylaxis was used in 81 patients (76 levofloxacin, 5 amoxicillin-clavulanate); 2 were already on IV antibiotics for a pre-existing infection, and 10 received no prophylaxis. Of the patients…
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.