| Objective:The object of this study was to evaluate the clinical efficacy and safety of Venetoclax combine with hypomethylating agents(HMA)for elderly acute myeloid leukemia by meta-analysis.Methods:Clinical studies concerning treatment of elderly acute myeloid leukemia with venetoclax and HMA were searched from Pub Med,Cochrane Library,Web of Science,Ovid,Science Direct,Wan Fang,and China National Knowledge Infrastructure(CNKI)databases up to October 2020.The statistical analysis was done in STATA12.0 software.11 studies were included in our study all of them concerning about the efficacy of venetoclax combine with HMA for elderly acut,5 of them compared the results of different hypomethylating agent:decitabine and azacytidine.2 of them showed adverse effects of the regiments.Results:The meta-analysis results showed that the regiment of venetoclax combine with HMA is effective for elderly acute myeloid leukemia,the estimated effects of the regiment was 65%for ORR(95%CI:53%-76%)(P=0.000,I~2=92.2%)and 51%(95%CI:36%-66%)for CR rate.Subgroup analysis showed that the pooled estimated CR rate of venetoclax plus azacytidine was 40%(95%CI:35%-45%),the pooled estimated for decitabine was 41%(95%CI:36%-44%).For ORR,the pooled estimated of venetoclax plus azacytidine was 65%(95%CI:61%-70%),the pooled estimated for decitabine was 50%(95%CI:43%-58%).For safety analysis,the incidence of grade 3 and grade 4 febrile neutropenia was 42%(95%CI:37%-447%),The incidence of grade 3 and grade 4 thrombocytopenia was44%(95%CI:37%-47%),the incidence of grade 3 and 4 neutropenia was41%(95%CI:36%-46%).Conclusions:This meta-analysis indicated that venetoclax combine with hypomethylating agent is an effective and safety regiment for elderly acute myeloid leukemia,and venetoclax plus azacytidine seems more superior than combination with decitabine. |
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