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iwAL 2026 | Current evidence base for de-escalating venetoclax in AML

Stéphane De Botton, MD, PhD, Gustave Roussy Institute, Paris, France, discusses the current evidence base for de-escalating venetoclax duration in patients with acute myeloid leukemia (AML) who achieve early, deep remission, noting that it is too early to determine when to stop treatment based on flow cytometry. Dr De Botton highlights the importance of monitoring measurable residual disease (MRD) using PCR, particularly in patients with NPM1 mutations. This interview took place at the 8th International Workshop on Acute Leukemias (iwAL 2026), held in Boston, MA.

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Transcript

It is too early to determine when to stop an aza based on flow cytometry. I think it’s too early and nothing is really very clear. Within NPM1, we have flavors that could be feasible, provided we have enough duration of drug exposure. And in case of negativity, this is a strong biological marker. So we can monitor NPM1. And if after five to six weeks, every five to six weeks, and if you see a rise, a significant rise in minimal residual disease assessed by PCR, in that case, we can restart the treatment...

It is too early to determine when to stop an aza based on flow cytometry. I think it’s too early and nothing is really very clear. Within NPM1, we have flavors that could be feasible, provided we have enough duration of drug exposure. And in case of negativity, this is a strong biological marker. So we can monitor NPM1. And if after five to six weeks, every five to six weeks, and if you see a rise, a significant rise in minimal residual disease assessed by PCR, in that case, we can restart the treatment. Otherwise, for other situations, it’s much more complicated.

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