Targeted venetoclax therapy of 11;14 translocated multiple myeloma
Szita Virág Réka
KÁROLY RÁCZ CONSERVATIVE MEDICINE PROGRAM
Dr. Fekete Andrea
SE Belgyógyászati és Hematológiai Klinika Könyvtár
2026-06-04 14:00:00
Clinical Haematology
Dr. Masszi Tamás
Dr. Varga Gergely
Dr. Bátai Bence
Dr. Szomor Árpád
Dr. Karádi István
Dr. Peskó Gergely
Dr. Szaleczky Erika
Despite the introduction of more and more novel agents, multiple myeloma remains incurable for the majority of patients; treatment options that are reliably curative are an unmet need. Venetoclax, a selective BCL-2 inhibitor was shown to be contraindicated in the general myeloma population due to excess mortality, but demonstrated promising results in patients with translocation t(11;14). Its optimal application however remains in question. We evaluated venetoclax use in t(11;14) myeloma in a country-wide data collection in Hungary as well as in a more in depth analysis among our own patients at the Department of Internal Medicine and Hematology, Semmelweis University. Seven hematology centers participated, reporting 58 patients who we divided into two groups based on their history: 37 patients were treated in the relapsed/refractory setting with few or no other therapeutic options available; and 21 patients started venetoclax as salvage after failing to achieve satisfactory response to first line therapy. In the relapsed/refractory setting objective response rate (ORR) was 94%, median progression-free survival (PFS) 10.0 months and median overall survival (OS) 14.6 months. In reinduction patients, ORR was 100%, median PFS and OS were not reached, and all eligible patients could proceed to ASCT. Importantly, we found high risk features such as deletion 17p or renal failure had no adverse effect on survival, moreover, renal failure ameliorated after venetoclax therapy in 42% of the cases, including three patients who became dialysis independent. Our study also reported the highest number of plasma cell leukemia cases successfully treated with venetoclax published in literature at the time, with refractory plasma cell leukemia patients achieving a median PFS of 10.0 and a median OS of 12.2 months.
