e18621 Background: Azacitidine with Venetoclax was approved in 2020 for older patients ineligible for intensive chemotherapy (DiNardo C, et al. NEJM 2020). Ony 3% of this trial population were of racial minority. Since then, a few studies have assessed disparate AML outcomes among racial minorities in modern era of therapeutics; outcomes have largely involved social determinants of health (SDOH) (Bouligny, I, et al Blood 2022). The ease of administration and efficacy of this regimen allow for its use in the community setting. We aim to analyze Venetoclax utilization patterns based on age, race, and outcomes in our patient population in Memphis, TN. Methods: A retrospective cohort study involving three cancer centers in Memphis, TN from January 2017 to March 2023 was conducted. Inclusion criteria were patients ages 18-85 diagnosed with Acute myeloid leukemia (AML) and in receipt of Venetoclax-based therapies. Number of lines of therapy, demographics, adverse events, and other outcomes were annotated per case. Of 558 patients reviewed,101 patients met inclusion criteria. For simple comparative analysis, Fischer Exact test was performed. Cox proportional hazard and log-rank test were utilized to assess survival outcomes. Results: Median age at diagnosis was 68 years, and 45.5% of patients were female gender. 24.8% of patients were non-Hispanic Black (NHB), 74.3% non-Hispanic White (NHW) and 1% Hispanic patients. Mean number of medical co-morbidities per case was 1.82. 9.2% of patients were good risk per ELN criteria, 32.6% intermediate, and 58.9% were poor risk. Azacitidine was used in the first line setting with Venetoclax in 74% of patients and in 31% in the second line. Between NHB and NHW cohorts, the median age at diagnosis of AML was 63 vs. 70.5 years, p=.0026 respectively. NHW patients had higher ELN intermediate risk disease; 38.4% versus 14.3%, p= .0235. There was no difference between cohorts regarding complete response rates (p= .4858). Survival data was available for 76 patients; log-rank test stratified by cytogenetic risk and age showed no statistically significant difference observed (p = 0.60). Median OS for NHB was 16.2 months (95% CI 8.4- N/A) and NHW was 19.53 months (95% CI 12.93- 31.56). After adjustment for cytogenetic risk and age in a Cox proportional hazards model, AML outcomes did not differ significantly between NHW and NHB patients (HR = 0.95, 95% CI 0.45–2.02; p = 0.88). Regarding adverse events, 22.7% of NHB developed acute renal failure compared to 1.4% of NHW, p= .0035. Conclusions: This retrospective cohort study highlights the utilization patterns of Venetoclax and race-based differences in Memphis, TN. The median age of diagnosis of AML in NHB patients was lower at diagnosis; further germline predisposition data needs to be evaluated. NHB patients had a higher percentage of development of renal failure, which needs to be validated with a larger cohort.
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