e18511 Background: VIALE-A established Aza and Venetoclax (Ven) as first-line therapy (1L) for acute myeloid leukemia for patients (pts) ineligible for intensive chemotherapy. Real-world (RW) use of Ven often differs in dose, schedule, timing of bone marrow biopsy (Bmbx) to assess response, and use of concomitant medications. We examined RW outcomes with 1L Ven at our center. Methods: Our cohort was diagnosed from 2018-2023. Chart abstraction was completed for 160 pts (data cutoff (DCO) 1 Dec 2025) to capture Ven dosing and duration, mutations, concomitant medications, Bmbx, and hematologic adverse events (HAE). Duration of remission (DoR) was defined as time from 1st composite complete response (CRc, per IWG criteria) to relapse, death, or start of 2L, with censoring at transplant or DCO. Ven dose intensity was calculated from dose, duration, and CYP3A inhibitor use. Differences were assessed using the log-rank test, with p10% still in remission at DCO. Mutation status significantly influenced DoR, whereas Ven duration >21 d or C1 dose intensity did not influence time to CRc or occurrence. Despite RW treatment variability, outcomes were comparable to VIALE-A. These results support the use of 21d Ven duration during induction to optimize the balance between achievement of CRc and DoR. The observed association between HAE and CRc is interesting and warrants further study as a potential prognostic marker.
Chang et al. (Thu,) studied this question.