Selinexor Combined With Azacitidine Therapy in High-Risk Myeloid Neoplasms Patients

Inclusion Criteria

• •with pre-transplant MRD-positive AML, i.e., patients who meet one of the following criteria:
• •1. Age≥ 16 years old; any gender;
• •2. High-risk MDS (IPSS-R or/and IPSS-M high-risk and above);
• •3. High relapse risk AML, including relapsed refractory AML and patients with pre-transplant MRD-positive AML, i.e., patients who meet one of the following criteria:
• •(1)Refractory AML is defined as meeting one of the following conditions
• •1. Primary cases that have failed to respond to 2 courses of standard regimen chemotherapy;
• •2. CR was followed by consolidation and intensive treatment with no recurrence within 12 months;
• •3. It recurred 12 months later, but conventional chemotherapy was ineffective;
• •4. 2 or more relapses;
• •5. Extramedullary leukemia persists. (2)Relapsed AML i.e., re-initialization of leukemic cells in the peripheral blood after complete remission (CR) or bone marrow primitive cells \>0.050 (except for other reasons such as bone marrow reconstitution after consolidation chemotherapy) or extramedullary infiltration of leukemic cells.
• •(3)Positive pre-transplant MRD, i.e., one of the following conditions is met:
• •1. Proportion of abnormal myeloid cells \>0.01% by pre-transplant flow assay;
• •2. Positive pre-transplantation molecular biology-related tests. (4)AML with poor prognosis (according to the Chinese Guidelines for the Diagnosis and Treatment of Adult Acute Myeloid Leukemia (Non-Acute Promyelocytic Leukemia) 2023 Edition) 4.Meets WHO diagnostic criteria for staging CMML; 5.MDS or CMML transforms AML.