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Three hundred and fifty R\/R AML patients receiving venetoclax and azacitidine (VA) regimen or VA plus homoharringtonine (VAH) regimen as salvage therapy were enrolled in this study, with a higher composite complete remission rate in the VAH group (69.9%) than in the VA group (46.1%). A total of 105 patients underwent allo\u2010HSCT, with a median follow\u2010up post\u2010transplantation of 37.2\u2009months. The 3\u2010year cumulative incidence of transplant\u2010related mortality was 18.2% in the VA group and 9.8% in the VAH group. The 3\u2010year cumulative incidence of relapse was lower in the VAH group (19.7%) than in the VA group (43.2%). The 3\u2010year overall survival and event\u2010free survival (EFS) were 82.0% and 70.5%, respectively, in the VAH group, which were higher than 59.1% and 38.6%, respectively, in the VA group. Multivariate analysis revealed the VAH regimen and MRD\u2010negative at transplantation were protective factors for relapse (HR\u2009=\u20090.427 and HR\u2009=\u20090.368) and EFS (HR\u2009=\u20090.469 and HR\u2009=\u20090.384). In conclusion, the VAH regimen is an effective and safe salvage therapy bridge to allo\u2010HSCT for R\/R AML patients compared with the VA regimen.<\/jats:p>","DOI":"10.1111\/bjh.20147","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T23:28:27Z","timestamp":1747870107000},"page":"151-161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Venetoclax plus azacitidine with or without homoharringtonine followed by allogeneic haematopoietic cell transplantation in patients with relapsed\/refractory acute myeloid leukaemia: A multicentre cohort study"],"prefix":"10.1111","volume":"207","author":[{"given":"Yiling","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Hematology Nanfang Hospital, Southern Medical University  Guangzhou China"},{"name":"School of Basic Medical Sciences Southern Medical University  Guangzhou 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