{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:49:46Z","timestamp":1782730186437,"version":"3.54.5"},"reference-count":59,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T00:00:00Z","timestamp":1757721600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Research Council (DFG)","award":["HE6233\/16-2"],"award-info":[{"award-number":["HE6233\/16-2"]}]},{"name":"German Research Council (DFG)","award":["HE6233\/9-1"],"award-info":[{"award-number":["HE6233\/9-1"]}]},{"name":"German Research Council (DFG)","award":["HE6233\/10-1"],"award-info":[{"award-number":["HE6233\/10-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Chronic kidney disease (CKD) before treatment and renal function decline during treatment are common in elderly patients receiving hypomethylating agents (HMAs) and venetoclax (VEN). This retrospective multicenter study of 130 newly diagnosed older acute myeloid leukemia (AML) patients evaluated the prognostic impact of renal function before and during the first treatment cycle. A total of 56 patients (43%) had CKD, and 49 (38%) developed acute kidney injury (AKI) during treatment. AKI occurrence was associated with laboratory tumor lysis syndrome (LTLS). CKD before treatment showed a trend towards a lower overall response rate (ORR, OR 0.5, p = 0.07) in multivariable analysis (MVA) and inferior relapse-free survival (RFS, HR 2.16, p = 0.06) in univariate analysis (UVA), but not MVA (RFS, HR 1.93, p = 0.15). CKD did not affect overall survival (OS) or event-free survival (EFS). AKI during HMA\/VEN therapy was associated with significantly higher 30-day and 60-day mortality rates and emerged as an independent prognostic factor for inferior OS (HR 1.86, p = 0.01) and EFS (HR 1.81, p = 0.007). RFS did not differ significantly by AKI status. Sepsis was a more frequent cause of death in patients with vs. without AKI (33% vs. 5%). In conclusion, kidney function is a key prognostic factor in HMA\/VEN-treated patients, warranting further study on treatment adjustments and supportive care.<\/jats:p>","DOI":"10.3390\/cancers17182993","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T09:43:41Z","timestamp":1757929421000},"page":"2993","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Role of Kidney Disease in Newly Diagnosed Acute Myeloid Leukemia Under Venetoclax-Based Low-Intensity Therapy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6116-7947","authenticated-orcid":false,"given":"Katja","family":"Kr\u00fcger","sequence":"first","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4780-1134","authenticated-orcid":false,"given":"Razif","family":"Gabdoulline","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-565X","authenticated-orcid":false,"given":"Bernhard M. W.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Hypertension, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"G\u00f6tze","sequence":"additional","affiliation":[{"name":"Department of Medicine III, School of Medicine and Health, Technical University of Munich (TUM), 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krischan","family":"Braitsch","sequence":"additional","affiliation":[{"name":"Department of Medicine III, School of Medicine and Health, Technical University of Munich (TUM), 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Schmalbrock","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 12203 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Bullinger","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology, and Cancer Immunology, Campus Benjamin Franklin, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 12203 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-3310","authenticated-orcid":false,"given":"Franziska","family":"Westendorf","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0275-8803","authenticated-orcid":false,"given":"Walter","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke K.","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Hannover Medical School, 30625 Hannover, Germany"},{"name":"Clinical Genetics and Genomic Medicine, University Hospital W\u00fcrzburg, 97078 W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Krauter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Municipal Hospital Braunschweig, 38126 Braunschweig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7574-2522","authenticated-orcid":false,"given":"Stephan","family":"Kaun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Municipal Hospital Bremen-Mitte, 28205 Bremen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9647-5024","authenticated-orcid":false,"given":"Andreas","family":"Vo\u00df","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology, University Clinic Oldenburg, 26133 Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-0461","authenticated-orcid":false,"given":"Elisabeth","family":"Koller","sequence":"additional","affiliation":[{"name":"3rd Medical Department, Hanusch Hospital, 1140 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Germing","sequence":"additional","affiliation":[{"name":"Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University D\u00fcsseldorf, 40225 D\u00fcsseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7682-8563","authenticated-orcid":false,"given":"Kai","family":"Wille","sequence":"additional","affiliation":[{"name":"University Clinic for Haematology, Oncology, Haemostaseology and Palliative Care Johannes-Wesling-Klinikum Minden, Ruhr-University Bochum, 32429 Minden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Grie\u00dfhammer","sequence":"additional","affiliation":[{"name":"University Clinic for Haematology, Oncology, Haemostaseology and Palliative Care Johannes-Wesling-Klinikum Minden, Ruhr-University Bochum, 32429 Minden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Braess","sequence":"additional","affiliation":[{"name":"Department of Oncology and Hematology, Hospital Barmherzige Brueder Regensburg, 93049 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3304-6598","authenticated-orcid":false,"given":"Daniel","family":"F\u00f6hring","sequence":"additional","affiliation":[{"name":"Evang. Krankenhaus Essen-Werden, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Reimer","sequence":"additional","affiliation":[{"name":"Evang. Krankenhaus Essen-Werden, 45239 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Medical Department II, St. Bernwards Hospital, 31134 Hildesheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Kirchen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Krankenhaus der Barmherzigen Br\u00fcder, 54292 Trier, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Hospital Lippe, 32657 Lippe, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan M.","family":"Middeke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3791-0548","authenticated-orcid":false,"given":"Christoph","family":"R\u00f6llig","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Dresden, Technical University Dresden, 01307 Dresden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"D\u00f6hner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstanze","family":"D\u00f6hner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital of Ulm, 89081 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Beutel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5848-6152","authenticated-orcid":false,"given":"Felicitas R.","family":"Thol","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian H.","family":"Heidel","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Heuser","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"},{"name":"Department of Internal Medicine IV, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, 06120 Halle, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6266-6316","authenticated-orcid":false,"given":"Rabia","family":"Shahswar","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMoa2012971","article-title":"Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia","volume":"383","author":"Dinardo","year":"2020","journal-title":"N. 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