METHODS article
Front. Pharmacol.
Sec. Drug Metabolism and Transport
This article is part of the Research TopicAdvancements and Strategies in Predicting and Managing Clinical Drug-Drug InteractionsView all 7 articles
Venetoclax concentration affects the incidence of haematological adverse events in patients with acute myeloid leukaemia
Provisionally accepted
- 1Guangyuan Central Hospital, Guangyuan, China
- 2Sichuan Provincial People’s Hospital, chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction Venetoclax (VEN) demonstrates considerable inter-individual variability in drug exposure, and its pharmacokinetics are substantially influenced by concurrent administration of CYP3A inhibitors. This study explores the relationship between VEN exposure and the incidence of haematological adverse events (AEs) in patients by quantifying systemic VEN concentrations. Methods We retrospectively analyzed data from 114 patients who received VEN therapy. Among these, 52 were treated with VEN combined with azacitidine (AZA, days 1–7), 20 received VEN+AZA combined with omeprazole (OPZ), 20 received VEN+AZA combined with voriconazole (VCZ), and 22 received VEN+AZA combined with posaconazole (PCZ). High-performance liquid chromatography was used to determine the plasma steady-state C min and C max of VEN (n=114), and the plasma steady-state C min of VCZ (n=20) and PCZ (n=22). Results The effect of combined medication on VEN concentration was as follows: VEN + PCZ group/VEN + VCZ group > VEN + OPZ group > VEN group. Increased VEN concentration increased the incidence of Grade 3 or higher haematological AEs. CYP3A inhibitors increased VEN levels, thereby increasing the risk of AEs. A VEN C max value of 4886.00 ng/mL had the highest predictive value for mitigating AEs in patients presenting with Grade ≥3 neutropenia and thrombocytopenia. Conclusions VEN concentration is correlated with the occurrence of haematological AEs, and VEN concentrations can be used to predict the occurrence of haematological AEs.
Keywords: Venetoclax1, concentration2, combination medication3, CYP3A inhibitors4, haematological adverse events5
Received: 22 Sep 2025; Accepted: 27 Nov 2025.
Copyright: © 2025 Chen, Yang, Xie, Zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jing Chen
Xi Yang
LI Juan Zhang
Lu Chen
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.