Clinical Report: Combination Therapy of Venetoclax and Azacitidine for MDS

Background

Multiple myeloma (MM) is a hematological malignancy that can lead to treatment-related complications such as therapy-related myelodysplastic syndrome (t-MDS). t-MDS occurs at higher rates in long-term survivors of MM and poses significant challenges for patient management. The combination of venetoclax and azacitidine has shown promise in treating primary MDS and acute myeloid leukemia, and there is emerging literature on its application in t-MDS following MM.

Data Highlights

Clinical data is available in the article, detailing the case of a 74-year-old male with secondary MDS.

Key Findings

• A 74-year-old male developed secondary MDS characterized by refractory anemia with excess blasts-2 (MDS-RAEB-II) 51 months after initial MM diagnosis.
• The patient achieved morphological partial remission following treatment with venetoclax and azacitidine.
• Non-adherence to continuous treatment contributed to the patient's decline and eventual death from a secondary infection.
• Long-term survivors of MM are at increased risk for developing t-MDS and t-AML.
• The combination of venetoclax and azacitidine has demonstrated efficacy in primary MDS and AML, as supported by existing literature.

Clinical Implications

Clinicians should be aware of the potential for t-MDS in long-term MM survivors and consider combination therapies like venetoclax and azacitidine.

Conclusion

The case underscores the need for careful monitoring and management of treatment adherence in patients with secondary MDS following multiple myeloma.

Related Resources & Content

1. NCCN Guidelines® Insights, Version 2.2025 -- Myelodysplastic Syndromes
2. The ASCO Post, Doublet Therapy Yields Higher Response Rates and Fewer Complications Than Standard Induction in AML
3. The ASCO Post, Addition of Venetoclax to Azacitidine in Acute Myeloid Leukemia
4. The ASCO Post, Benefit of Azacitidine Plus Venetoclax Confirmed in AML
5. The ASCO Post — Benefit of Azacitidine Plus Venetoclax Confirmed in AML KEY POINTS
6. NCCN Guidelines® Insights: Myelodysplastic Syndromes, Version 2.2025 - PubMed
7. Efficacy and safety of venetoclax plus azacitidine for patients with treatment-naive high-risk myelodysplastic syndromes - ScienceDirect
8. Characteristics and Outcomes of Patients With Multiple Myeloma Who Developed Therapy-Related Acute Myeloid Leukemia and Myelodysplastic Syndrome After Autologous Cell Transplantation - PubMed