{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:36:42Z","timestamp":1777225002519,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venetoclax plus azacitidine (V+A) is standard for older, intensive\u2010ineligible patients with acute myeloid leukemia (AML). Its expanding use in younger, curative\u2010eligible adults lacks comparative evidence against conventional 7+3 induction, raising uncertainty about potential survival compromise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed an age\u2010stratified, retrospective comparative effectiveness study using de\u2010identified TriNetX electronic health records (2018\u20132025). Adults receiving first\u2010line V+A or 7+3 were propensity\u2010matched 1:1 within prespecified age groups (18\u201359; \u226560) by demographics, comorbidities, socioeconomic factors, and performance status. The primary endpoint was 1\u2010year all\u2010cause mortality; secondary endpoints included complete remission and ICU admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, 214 younger and 1724 older adults per arm were analyzed. Among younger adults, V+A was associated with significantly higher 1\u2010year mortality versus 7+3 (20.6% vs. 8.9%; HR 2.55), with a number needed to harm of nine. Remission rates favored intensive induction (53.3% vs. 44.9%), while ICU use was similar. In older adults, mortality differences were smaller (23.1% vs. 20.5%; HR 1.34; NNH 38), though remission again favored 7+3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>V+A appears markedly inferior to 7+3 as first\u2010line therapy in younger, curative\u2010eligible AML, producing a nearly fourfold greater harm signal than in older adults. These findings support restricting V+A to intensive\u2010ineligible patients pending randomized confirmation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70253","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:01:35Z","timestamp":1772989295000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Analysis of Outcomes of Venetoclax+Azacitidine Versus 7+3 Induction in Acute Myeloid Leukemia"],"prefix":"10.1002","volume":"7","author":[{"given":"Nehemias","family":"Guevara Rodriguez","sequence":"first","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplantation, Department of Internal Medicine Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemy Coreas","family":"Mercado","sequence":"additional","affiliation":[{"name":"Division of Gynecologic Oncology, Department of Oncology National University of El Salvador  San Salvador El Salvador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syeda Ashna Fatima","family":"Kamal","sequence":"additional","affiliation":[{"name":"Division of Hospice and Palliative Medicine, Department of Internal Medicine Saint Louis University School of Medicine\/SSM Health Saint Louis University Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Beesabathina","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Meharry Medical College  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawson","family":"Foster","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplantation, Department of Internal Medicine Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabeel","family":"Rajeh","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplantation, Department of Internal Medicine Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranju","family":"Kunwor","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, and Bone Marrow Transplantation, Department of Internal Medicine Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904544"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0901409"},{"key":"e_1_2_12_4_1","first-page":"1891","article-title":"Randomized Comparison of 7+3 Versus FLAG\u2010Ida in Younger Adults (UK NCRI AML17)","volume":"38","author":"Burnett A.","year":"2020","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1406184"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(06)69780\u20108"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(12)61727\u20109"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2012971"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01600"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507471"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1516192"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.4600"},{"key":"e_1_2_12_13_1","first-page":"561","article-title":"Measurable Residual Disease at Post\u2010Induction Predicts Outcome in AML","volume":"131","author":"Freeman S. D.","year":"2018","journal-title":"Blood"},{"key":"e_1_2_12_14_1","first-page":"2426","article-title":"Significance of MRD in AML","volume":"117","author":"Walter R. B.","year":"2011","journal-title":"Blood"},{"key":"e_1_2_12_15_1","first-page":"190","article-title":"Venetoclax for AML: Biology and Therapy","volume":"134","author":"Pollyea D. A.","year":"2019","journal-title":"Blood"},{"key":"e_1_2_12_16_1","first-page":"27","article-title":"Racial Disparities in AML Survival","volume":"79","author":"Shallis R. M.","year":"2019","journal-title":"Leukemia Research"},{"key":"e_1_2_12_17_1","first-page":"5818","article-title":"Racial Differences in AML Outcomes","volume":"115","author":"Sekeres M. A.","year":"2009","journal-title":"Cancer"},{"key":"e_1_2_12_18_1","first-page":"2079","article-title":"Age and Race Disparities in AML Survival","volume":"23","author":"Patel M. I.","year":"2012","journal-title":"Cancer Causes & Control"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102015\u201007\u2010604546"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016867"},{"key":"e_1_2_12_21_1","first-page":"318","article-title":"Therapeutic Options in AML\u2014Risk Stratification and Treatment","volume":"88","author":"Estey E. H.","year":"2013","journal-title":"American Journal of Hematology"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1158\/2159\u20108290.CD\u201016\u20100313"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-08-733196"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.02.018"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024027217"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102022\u2010162525"},{"key":"e_1_2_12_27_1","first-page":"289","article-title":"Venetoclax + FLT3 Inhibitors in Relapsed\/Refractory FLT3\u2010Mutated AML (Early\u2010Phase)","volume":"35","author":"Daver N.","year":"2021","journal-title":"Leukemia"},{"key":"e_1_2_12_28_1","first-page":"352","article-title":"Triplet Regimens Using Venetoclax With Targeted Agents in AML (Phase 1\/2 Experience)","volume":"5","author":"DiNardo C. D.","year":"2021","journal-title":"Blood Advances"},{"key":"e_1_2_12_29_1","first-page":"631","article-title":"Outcomes of Venetoclax\u2010Based Combinations by Genomic Subset","volume":"107","author":"Lachowiez C. A.","year":"2022","journal-title":"Haematologica"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70253","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jha2.70253","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:15:53Z","timestamp":1777223753000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/jha2.70253"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70253","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]},"assertion":[{"value":"2025-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70253"}}