Evidence map›Paper›PMID 41654609›Full record

ArticleScientific reports2026

Impact of venetoclax trough levels on safety and efficacy in the treatment of acute myeloid leukemia.

Hiromi Hayashi, Takeo Yamagiwa, Junya Kanda, Takayuki Ishikawa, Masashi Sawa, Yasuko Miyahara, Takayoshi Tachibana, Mitsumasa Watanabe, Yasunori Ueda, Yasuhiko Tsutsumi and 30 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Hiromi HayashiDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Takeo YamagiwaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Junya KandaDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan. jkanda16@kuhp.kyoto-u.ac.jp.
Takayuki IshikawaDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.
Masashi SawaDepartment of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
Yasuko MiyaharaDepartment of Hematology, Kyoto City Hospital, Kyoto, Japan.
Takayoshi TachibanaDepartment of Hematology and Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Mitsumasa WatanabeDepartment of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
Yasunori UedaDepartment of Hematology, Kurashiki Central Hospital, Kurashiki, Japan.
Yasuhiko TsutsumiDepartment of Hematology, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan.
Kazunori ImadaDepartment of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan.
Shin-Ichiro FujiwaraDivision of Hematology, Jichi Medical University, Shimotsuke, Japan.
Tomomi ToubaiDivision of Hematology and Cell Therapy, Yamagata University Hospital, Yamagata, Japan.
Kota YoshifujiDepartment of Hematology, Institute of Science Tokyo, Tokyo, Japan.
Hirokazu HirataDepartment of Hematology, Kansai Electric Power Hospital, Osaka, Japan.
Hiroshi KawabataDepartment of Hematology, NHO Kyoto Medical Center, Kyoto, Japan.
Masaaki TsujiDepartment of Hematology, Japanese Red Cross Otsu Hospital, Otsu, Japan.
Satoshi WakitaDepartment of Hematology, Nippon Medical School, Tokyo, Japan.
Hiroki YokoyamaDivision of Clinical Oncology/Hematology, Jikei University School of Medicine, Tokyo, Japan.
Toshiyuki KitanoDepartment of Hematology, Medical Research Institute Kitano Hospital, Osaka, Japan.
Kazunori MuraiDepartment of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan.
Yoshihisa KataokaDepartment of Hematology, Ikeda City Hospital, Ikeda, Japan.
Eri KawataDepartment of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan.
Shun-Ichi KimuraDivision of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
Ryusuke YamamotoDepartment of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan.
Kotaro MiyaoDepartment of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan.
Daisuke NakayamaDepartment of Hematology, Kyoto City Hospital, Kyoto, Japan.
Akihiko IzumiDepartment of Hematology and Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Takahito KawataDepartment of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.
Yoshiyuki OndaDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Takashi SakamotoDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Chisaki MizumotoDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Toshio KitawakiDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Kouhei YamashitaDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.
Atsushi YonezawaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Tomoya KawakamiDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Shunsaku NakagawaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Risa TaniguchiDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Tomohiro TeradaDepartment of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan.
Akifumi Takaori-KondoDepartment of Hematology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, 606-8507, Kyoto, Japan.

Funding

Japan Society for the Promotion of Science 24K11515
6 · The paper itself

Abstract

Venetoclax-azacitidine chemotherapy is a key treatment for older or medically unfit patients with acute myeloid leukemia (AML). As venetoclax is metabolized via cytochrome P450 3 A, dose adjustments are required when combined with antifungal agents. However, data on venetoclax concentrations and their impact on safety and efficacy remain limited. This study analyzed the association between venetoclax trough levels and treatment outcomes in 152 AML patients (median age: 70 years). The median trough level was 1,518 ng/mL (range: 60-11,328 ng/mL), with significant interindividual variability, even after adjusting for antifungal use. High venetoclax trough levels were significantly associated with elevated creatinine and total bilirubin levels. Patients with trough levels below 1857.3 ng/mL had lower rates of hematologic toxicity during the first treatment cycle (92.9% vs. 100%, P = 0.041). In the second cycle, hematologic toxicity was lower in patients with concentrations below 1,299.3 ng/mL (68% vs. 90%, P = 0.009). In the treatment-naïve group, trough levels above 1857.3 ng/mL were associated with a higher composite complete remission rate (77.3% vs. 47.8%, P = 0.042). These findings highlight the need for venetoclax dose optimization based on drug levels to improve both safety and efficacy in AML treatment.

Indexed as

Antineoplastic AgentsBridged Bicyclo Compounds, HeterocyclicLeukemia, Myeloid, AcuteSulfonamidesAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedTreatment OutcomeAntineoplastic AgentsBridged Bicyclo Compounds, HeterocyclicSulfonamidesvenetoclax

Identifiers

PMID41654609
PMCPMC12946174

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.