VA方案治疗AML发生严重血液学不良反应的影响因素分析OA

Objective To investigate the protective factors against severe hematological adverse reac-tions and their predictive value in patients with acute myeloid leukemia(AML)treated with the venetoclax combined with azacitidine(VA)regimen.Methods A retrospective analysis was conducted on the clinical da-ta of 84 AML patients who received VA regimen treatment at Henan Provincial Hospital of Traditional Chi-nese Medicine from May 2022 to August 2024.According to the Common Terminology Criteria for Adverse E-vents,the hematological adverse events(AEs)of the patients were assessed,and they were divided into a group without grade≥3 hematological AEs(non-occurrence group,n=51)and a group with grade≥3 hema-tological AEs(occurrence group,n=33).Univariate analysis was first performed to compare the differences between the two groups and screened for statistically significant variables.Subsequently,these variables were incorporated into a binary logistic regression model to analyze the influencing factors for the occurrence of grade≥3 hematological AEs.Furthermore,receiver operating characteristic(ROC)curves and the corre-sponding area under the curve(AUC)were used to analyze the influencing factors identified by the binary lo-gistic regression analysis,in order to clarify the diagnostic value of each influencing factor individually and in combination.Results Binary logistic regression analysis showed that a fit result in initial Ferrara assessment,a lower bone marrow blast percentage,active bone marrow hyperplasia were protective factors against the oc-currence of≥grade 3 hematological AEs(OR=0.067,0.922,0.021,respectively;P<0.05),while lower ser-um GR level was a risk factor(OR=1.003,P<0.05).ROC curve results indicated that the AUCs for diagno-sing≥grade 3 hematological AEs in AML patients using pre-treatment bone marrow blast percentage,degree of bone marrow hyperplasia,and serum GR level alone and in combination were 0.818,0.655,0.664,and 0.922,respectively.The AUC for the combined diagnosis was higher than that for each individual test(P<0.05).Conclusion The initial Ferrara assessment results,the proportion of bone marrow blasts,the degree of bone marrow hyperplasia,and the GR level are factors influencing the occurrence of severe hematological AEs.This provides a basis for clinical evaluation and prediction of the efficacy post-VA treatment.