{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:55:07Z","timestamp":1792652107139,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2502700"],"award-info":[{"award-number":["2022YFC2502700"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070187"],"award-info":[{"award-number":["82070187"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370213"],"award-info":[{"award-number":["82370213"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>ASXL1<\/jats:italic> is one of the most frequently mutated genes in acute myeloid leukemia (AML) and retains adverse\u2010risk status in intensively treated cohorts according to 2022 European Leukemia Net (ELN) risk criteria. The therapeutic and prognostic impacts of hypomethylating agents (HMAs) and venetoclax in young adults with <jats:italic>ASXL1<\/jats:italic>\u2010mutated AML is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty\u2010one patients with <jats:italic>ASXL1<\/jats:italic>\u2010mutated AML \u2264\u200960\u2009years old were retrospectively analyzed. The effects of HMAs plus venetoclax on treatment response and its prognostic value were compared with intensive chemotherapy (IC) and HMAs combined with low\u2010intensity chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intensive chemotherapy independently predicted a worse treatment response (IC vs. HMA\u2009+\u2009venetoclax, OR\u2009=\u20090.183, 95% CI 0.048\u20130.693, <jats:italic>p<\/jats:italic>\u2009=\u20090.012) and inferior overall survival (OS) (IC vs. HMA\u2009+\u2009venetoclax, HR\u2009=\u20093.316, 95% CI 1.332\u20138.255, <jats:italic>p<\/jats:italic>\u2009=\u20090.010). After 15 patients with favorable cytogenetics or mutations were excluded, the HMA\u2009+\u2009venetoclax combination still outweighed IC with respect to treatment response (IC vs. HMA\u2009+\u2009venetoclax, OR\u2009=\u20090.063, 95% CI 0.012\u20130.332, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and OS (IC vs. HMA\u2009+\u2009venetoclax, HR\u2009=\u20093.072, 95% CI 1.216\u20137.758 <jats:italic>p<\/jats:italic>\u2009=\u20090.018) in patients with an adverse risk according to 2022 European Leukemia Net guidelines. Allogeneic hematopoietic stem cell transplantation independently predicted superior OS (HR\u2009=\u20090.234, 95% CI 0.088\u20130.626, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Additionally, in patients receiving HMAs combined with venetoclax, the G646fs variant of the <jats:italic>ASXL1<\/jats:italic> mutation was associated with a lower complete remission or with an incomplete hematological recovery rate (4\/7 vs. 2\/19, 42.9% vs. 10.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.026) and worse event\u2010free survival (median, 14.0\u2009months vs. not reach, <jats:italic>p<\/jats:italic>\u2009=\u20090.045).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HMAs and venetoclax could benefit newly diagnosed younger patients with <jats:italic>ASXL1<\/jats:italic>\u2010mutated AML.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.71037","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:18:49Z","timestamp":1752833929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Better Response and Prognosis of Venetoclax Plus Hypomethylating Agents Over Intensive Chemotherapy in Young Adults With Newly Diagnosed <scp><i>ASXL1<\/i><\/scp>\u2010Mutated Acute Myeloid Leukemia"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7606-9349","authenticated-orcid":false,"given":"Yiming","family":"Cai","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Rui","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengwen","family":"Ding","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judan","family":"Xie","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Jin","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinyan","family":"Xiao","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Xu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, Jiangsu Key Laboratory of Hematologic Diseases The First Affiliated Hospital of Soochow University  Suzhou P. R. China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology Soochow University  Suzhou P. R. 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