A Phase II Study of Cladribine and Low Dose Cytarabine in Combination With Venetoclax, Alternating With Azacitidine and Venetoclax, in Patients With Higher-risk Myeloproliferative Chronic Myelomonocytic Leukemia or Higher-risk Myelodysplastic Syndromes With Excess Blasts
Key claim: A Phase II study is evaluating whether cladribine, low-dose cytarabine, and venetoclax alternating with azacitidine and venetoclax can control higher-risk MDS with excess blasts and/or higher-risk CMML.
Abstract
To learn if the combination of cladribine, cytarabine, venetoclax, and azacitidine can help to control higher-risk myelodysplastic syndrome (MDS) with excess blasts and/or higher-risk chronic myelomonocytic leukemia (CMML).
Why this matters
Higher-risk CMML and MDS/MPN with excess blasts sit at the AML-adjacent end of the MDS/MPN overlap spectrum, where continuous HMA + venetoclax doublets often yield shallow or non-durable responses. This trial tests whether alternating an AML-style cladribine + low-dose cytarabine + venetoclax induction cycle with azacitidine + venetoclax adds disease-burden control without the toxicity of full intensive chemotherapy. It contrasts with the dominant AVENHIR/ASTX727+ven paradigm in CMML by importing a purine-analog-based intensification rhythm rather than relying on HMA backbone alone.