{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:29:56Z","timestamp":1787045396573,"version":"build-2736575974"},"reference-count":15,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Acute myeloid leukemia (AML) predominantly affects older patients, many of whom are ineligible for intensive chemotherapy. Although the VIALE-A trial demonstrated improved survival with azacitidine plus venetoclax, its strict eligibility criteria may limit generalizability to routine clinical practice. We therefore evaluated real-world outcomes at our institution.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective single-centre cohort study of adult AML patients ineligible for intensive chemotherapy. Patients received azacitidine monotherapy (2014\u20132018) or azacitidine plus venetoclax (2019\u20132023). Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier estimates and log-rank tests. VIALE-A eligibility was assessed retrospectively.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 21 patients met the inclusion criteria: 8 received azacitidine alone and 13 azacitidine plus venetoclax. Median age was 79\u00a0years. Patients receiving azacitidine plus venetoclax completed more treatment cycles (median 7 vs. 4). Median OS was 12.6 vs. 9.1\u00a0months with azacitidine alone (p=0.416). Median PFS was 10.0 vs. 8.1\u00a0months, respectively (p=0.707). Overall, only 66\u202f% of patients fulfilled the VIALE-A eligibility criteria.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Azacitidine plus venetoclax was associated with numerically longer OS and PFS, although differences were not statistically significant. Only two-thirds of patients would have met VIALE-A eligibility criteria, highlighting the challenges of translating trial outcomes into routine practice. Larger multicentre studies are warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/med-2026-1499","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:56:38Z","timestamp":1787043398000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of treatment outcomes for AML patients ineligible for intensive chemotherapy before and after the implementation of VEN\/AZA\u00a0\u2013\u00a0a retrospective cohort study"],"prefix":"10.1515","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7109-2549","authenticated-orcid":false,"given":"Norea","family":"Gruber","sequence":"first","affiliation":[{"name":"Karl Landsteiner University of Health Sciences , Krems an der Donau , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8701-2412","authenticated-orcid":false,"given":"Josef","family":"Singer","sequence":"additional","affiliation":[{"name":"Karl Landsteiner University of Health Sciences , Krems an der Donau , Austria"},{"name":"Department of Internal Medicine II , University Hospital Krems, Karl Landsteiner University of Health Sciences , Krems an der Donau , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"2026081808563413146_j_med-2026-1499_ref_001","unstructured":"Pelcovits, A, Niroula, R. Acute myeloid leukemia: a review. R I Med J 2013 2020;103:38\u201340."},{"key":"2026081808563413146_j_med-2026-1499_ref_002","doi-asserted-by":"crossref","unstructured":"Newell, LF, Cook, RJ. Advances in acute myeloid leukemia. BMJ 2021;375:n2026. https:\/\/doi.org\/10.1136\/bmj.n2026.","DOI":"10.1136\/bmj.n2026"},{"key":"2026081808563413146_j_med-2026-1499_ref_003","doi-asserted-by":"crossref","unstructured":"Kc, O, Ellithi, M, Bhatt, VR. Care of older adults with acute myeloid leukemia: the role of geriatric assessment. Curr Treat Options Oncol 2025;26:920\u20137. https:\/\/doi.org\/10.1007\/s11864-025-01341-5.","DOI":"10.1007\/s11864-025-01341-5"},{"key":"2026081808563413146_j_med-2026-1499_ref_004","doi-asserted-by":"crossref","unstructured":"Yadav, SK, Joshi, U, Hussein, G, Warsame, M, Liu, B, Shrestha, A, et al.. Evolving paradigms in acute myeloid leukemia: personalized approaches to therapy across age and risk groups. Cancers (Basel) 2025;17:2824. https:\/\/doi.org\/10.3390\/cancers17172824.","DOI":"10.3390\/cancers17172824"},{"key":"2026081808563413146_j_med-2026-1499_ref_005","doi-asserted-by":"crossref","unstructured":"DiNardo, CD, Pratz, K, Pullarkat, V, Jonas, BA, Arellano, M, Becker, PS, et al.. Venetoclax combined with decitabine or azacitidine in treatment-naive, elderly patients with acute myeloid leukemia. Blood 2019;133:7\u201317. https:\/\/doi.org\/10.1182\/blood-2018-08-868752.","DOI":"10.1182\/blood-2018-08-868752"},{"key":"2026081808563413146_j_med-2026-1499_ref_006","doi-asserted-by":"crossref","unstructured":"Lucijanic, M. Azacitidine and venetoclax in AML. N\u00a0Engl J Med 2020;383:2087\u20138. https:\/\/doi.org\/10.1056\/NEJMc2029153.","DOI":"10.1056\/NEJMc2029153"},{"key":"2026081808563413146_j_med-2026-1499_ref_007","doi-asserted-by":"crossref","unstructured":"DiNardo, CD, Jonas, BA, Pullarkat, V, Thirman, MJ, Garcia, JS, Wei, AH, et al.. Azacitidine and venetoclax in previously untreated acute myeloid leukemia. N\u00a0Engl J Med 2020;383:617\u201329. https:\/\/doi.org\/10.1056\/nejmoa2012971.","DOI":"10.1056\/NEJMoa2012971"},{"key":"2026081808563413146_j_med-2026-1499_ref_008","doi-asserted-by":"crossref","unstructured":"Solana-Altabella, A, Rodr\u00edguez-Veiga, R, Mart\u00ednez-Cuadr\u00f3n, D, Montesinos, P. A systematic review of venetoclax for the treatment of unfit AML patients in real-world: is all that glitters gold? Ann Hematol 2025;104:913\u201335. https:\/\/doi.org\/10.1007\/s00277-024-05891-w.","DOI":"10.1007\/s00277-024-05891-w"},{"key":"2026081808563413146_j_med-2026-1499_ref_009","doi-asserted-by":"crossref","unstructured":"Graf, R, Kreye, G, Pecherstorfer, M, Singer, J. Real-world evidence of imatinib treatment in younger and older patients with chronic myeloid leukaemia: a retrospective single centre analysis. Oncol Lett 2025;30:373\u20137. https:\/\/doi.org\/10.3892\/ol.2025.15119.","DOI":"10.3892\/ol.2025.15119"},{"key":"2026081808563413146_j_med-2026-1499_ref_010","doi-asserted-by":"crossref","unstructured":"Peyerl, H, Kreye, G, Pecherstorfer, M, Singer, J. Treatment of stage iv colorectal cancer: a retrospective cohort study assessing whether failure of first-line treatment indicates failure of second-line treatment. Mol Clin Oncol 2025;22:10. https:\/\/doi.org\/10.3892\/mco.2024.2805.","DOI":"10.3892\/mco.2024.2805"},{"key":"2026081808563413146_j_med-2026-1499_ref_011","doi-asserted-by":"crossref","unstructured":"Gangat, N, Dinardo, CD. Newly diagnosed acute myeloid leukemia in unfit patients: 2026 treatment algorithms. Blood Cancer J 2025;15:139. https:\/\/doi.org\/10.1038\/s41408-025-01346-1.","DOI":"10.1038\/s41408-025-01346-1"},{"key":"2026081808563413146_j_med-2026-1499_ref_012","doi-asserted-by":"crossref","unstructured":"Pratz, KW, Jonas, BA, Pullarkat, V, Dinardo, CD, Pollyea, DA, Wei, AH, et al.. Long-term follow-up of viale-a: venetoclax and azacitidine in chemotherapy-ineligible untreated acute myeloid leukemia. Am J Hematol 2024;99:615\u201324. https:\/\/doi.org\/10.1002\/ajh.27246.","DOI":"10.1002\/ajh.27246"},{"key":"2026081808563413146_j_med-2026-1499_ref_013","doi-asserted-by":"crossref","unstructured":"Willekens, C, Bazinet, A, Chraibi, S, Bataller, A, Decroocq, J, Arani, N, et al.. Reduced venetoclax exposure to 7\u00a0days vs. standard exposure with hypomethylating agents in newly diagnosed AML patients. Blood Cancer J 2025;15:68. https:\/\/doi.org\/10.1038\/s41408-025-01269-x.","DOI":"10.1038\/s41408-025-01269-x"},{"key":"2026081808563413146_j_med-2026-1499_ref_014","doi-asserted-by":"crossref","unstructured":"Montesinos, P, Recher, C, Vives, S, Zarzycka, E, Wang, J, Bertani, G, et al.. Ivosidenib and azacitidine in idh1-mutated acute myeloid leukemia. N\u00a0Engl J Med 2022;386:1519\u201331. https:\/\/doi.org\/10.1056\/nejmoa2117344.","DOI":"10.1056\/NEJMoa2117344"},{"key":"2026081808563413146_j_med-2026-1499_ref_015","doi-asserted-by":"crossref","unstructured":"D\u00f6hner, H, DiNardo, CD, Appelbaum, FR, Craddock, C, Dombret, H, Ebert, BL, et al.. Genetic risk classification for adults with AML receiving less-intensive therapies: the 2024 ELN recommendations. Blood 2024;144:2169\u201373. https:\/\/doi.org\/10.1182\/blood.2024025409.","DOI":"10.1182\/blood.2024025409"}],"container-title":["Open Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1499\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:56:40Z","timestamp":1787043400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/med-2026-1499\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,8,18]]},"published-print":{"date-parts":[[2026,1,23]]}},"alternative-id":["10.1515\/med-2026-1499"],"URL":"https:\/\/doi.org\/10.1515\/med-2026-1499","relation":{},"ISSN":["2391-5463"],"issn-type":[{"value":"2391-5463","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"article-number":"20261499"}}