{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T16:52:47Z","timestamp":1781542367853,"version":"3.54.5"},"reference-count":36,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Haematol"],"abstract":"<jats:p>Introduction: Chronic myelomonocytic leukemia (CMML) is a biologically heterogeneous myelodysplastic\/myeloproliferative neoplasm with limited disease-modifying treatment options beyond hypomethylating agents (HMAs) and allogeneic hematopoietic stem cell transplantation. Venetoclax, a selective BCL-2 inhibitor, is increasingly used off-label in CMML, but its CMML-specific efficacy and safety remain incompletely defined. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA 2020. Eligible studies included adult patients with CMML treated with venetoclax-based regimens and reporting extractable CMML-specific outcomes. PubMed, Embase, Cochrane CENTRAL, conference proceedings, and trial registries were searched through August 2025. Random-effects meta-analyses of proportions were performed for complete remission (CR), marrow complete remission (mCR), and overall response rate (ORR). Results: Seventeen publications representing nine unique studies were included, comprising 145 venetoclax-treated CMML patients. Most regimens combined venetoclax with azacitidine, decitabine, or oral decitabine-cedazuridine, with heterogeneous dosing schedules and frequent CYP3A-guided dose modifications. Responses typically occurred early, within one to two treatment cycles, but durability was generally modest. The pooled CR rate was 19.1% (95% CI: 9.4\u201334.9; I2 = 55%), the pooled mCR rate was 36.4% (95% CI: 24.7\u201350.0; I2 = 21%), and the pooled ORR was 71.9% (95% CI: 56.5\u201383.4; I2 = 56%). Venetoclax-based therapy was associated with substantial myelosuppression, including frequent grade \u22653 neutropenia and thrombocytopenia, with clinically relevant infectious complications. Early mortality was low in studies reporting short-term outcomes. Conclusion: Venetoclax-based regimens demonstrate measurable but limited activity in CMML, with high overall response rates but low CR rates and modest durability. Prospective CMML-specific trials are needed to define optimal dosing, clarify comparative effectiveness, and identify patients most likely to benefit.<\/jats:p>","DOI":"10.1159\/000551885","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:00:54Z","timestamp":1775577654000},"page":"1-16","source":"Crossref","is-referenced-by-count":0,"title":["Venetoclax-Based Regimens in Chronic Myelomonocytic Leukemia: A Systematic Review and Meta-Analysis"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0622-8455","authenticated-orcid":false,"given":"Mohammed","family":"Abdulgayoom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad S.","family":"Afana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen Haj","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aadhila Abbas","family":"Manthiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor A.","family":"Aweer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Bakheet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman F.","family":"Al-Mashdali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehab F.","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01613-1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27271"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-05-714030"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.bneo.2025.100116"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-08-452938"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.88"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2200008"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.801524"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023476"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071610"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00437"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2020-138680"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000937"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2024025464"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-19-0710"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-021-01240-2"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26504"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(23)00367-8"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(22)00216-2"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2022-165470"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/cts.13711"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2024-211307"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26334"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-024-02466-6"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-10-607341"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s40164-025-00652-5"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1080\/17501911.2025.2557179"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022018604"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021015173"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025030558"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-023-01705-z"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2024.285410"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27628"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-021-00541-0"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1097\/HS9.0000000000000583"}],"container-title":["Acta 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