Other regimens

In a phase II trial, 13 hypomethylating agent–naive patients with high-risk CMML were treated with azacitidine or decitabine plus venetoclax. With a median follow-up of 14.1 months, the overall response rate was 85% (11 of 13 patients), including two with complete response and a median duration of response of 17.9 months.[40,41][Level of evidence C3] Six of these patients underwent subsequent allogeneic SCT.

A retrospective study included 21 patients with high-risk CMML who received cladribine plus low-dose cytarabine alternating with azacitidine or decitabine. The patients had an objective response rate of 33% (50% in patients with hypomethylating agent–naive CMML and 23% in patients with hypomethylating agent–failure CMML).[41][Level of evidence C3]

A phase I/II study of 23 patients with mostly high-risk MDS and greater than 5% marrow blast cells involved 10 patients with CMML. All patients received azacitidine plus venetoclax. With a median follow-up of 13.2 months, the overall response rate was 87% (95% CI, 66%–97%).[42][Level of evidence C3]