Venetoclax and the Impact on Management of Older Patients With AML

Patients with acute myeloid leukemia (AML) have experienced a revolutionary change in treatment options with the introduction of venetoclax, particularly benefiting older adults and those unable to tolerate intensive chemotherapy. Previously, these patients faced limited treatment choices with median survival of only 8 to 9 months using single-agent hypomethylating agents, leading many to choose hospice care over treatment. Venetoclax combinations have dramatically improved response rates to 67% and extended median survival to 15 months, fundamentally changing the treatment landscape and giving patients real hope for meaningful life extension.

The impact extends beyond survival statistics to include improved quality of life and expanded treatment opportunities. Patients who maintain better performance status during venetoclax-based treatment may become eligible for bone marrow transplantation, an option previously unavailable due to the debilitating effects of intensive chemotherapy. The oral nature of venetoclax reduces the burden of daily clinic visits required with injectable treatments, allowing patients greater flexibility and independence during their treatment journey.

As venetoclax becomes standard care, patients benefit from ongoing research into optimal dosing, treatment duration, and combination approaches. Health care teams are learning to personalize venetoclax regimens based on individual patient factors, mutation profiles, and response patterns, leading to shorter treatment courses and reduced adverse effects while maintaining effectiveness. The success of venetoclax has opened doors to additional combination therapies and oral treatment regimens that promise to further improve outcomes while reducing treatment burden for patients facing this challenging diagnosis.