PMC7758129_01
Absolute neutrophil count (ANC), hemoglobin (Hgb), and platelet counts throughout mivebresib mono- or combination therapy with venetoclax. ANC was less than 100/muL during days 1 to 84, corresponding to cycles 1 to 3 of monotherapy (as denoted by grey triangle), and recovered to greater than 1,000/muL, thereafter. Hgb generally remained between 7 and 12 g/dL throughout all treatment modalities. Platelets remained less than 10,000/muL between days 140 and 190, corresponding to cycles 4 and 6 of monotherapy (as denoted by black oval), and then increased to 15,000 to 120,000/muL for the duration of the trial. M = mivebresib; V = venetoclax; E = eltrombopag.
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fig1
The patient first developed thrombocytopenia during cycle 2 and became transfusion dependent by cycle 5 (Figure 1 and Table 1).
Platelet count response to therapy. Platelets decreased to less than 10,000/muL with mivebresib 1.5 mg once daily monotherapy. Platelets increased to greater than 10,000/muL with a change in mivebresib dosing to 3 mg MWF and increased further to greater than 50,000/muL with the addition of eltrombopag. Platelet counts remained greater than 15,000/muL and up to 120,000/muL with the combination mivebresib and venetoclax and sustained with eltrombopag.
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fig2
Eltrombopag 50 mg daily was added during cycle 7, and mivebresib was modified from 1.5 mg daily to 3 mg MWF during cycle 8 resulting in decreased transfusion requirements (Figure 2).