Advanced Journal of Nursing

Objective: To investigate the clinical efficacy of combined therapy with Bcl-2 inhibitor (venetoclax), demethylating drug (azacitidine) and low-dose cytarabine in elderly patients with intermediate- or high-risk myelodysplastic syndromes (MDS). Methods: A total of 90 elderly patients with intermediate- or high-risk MDS admitted to our hospital from January 2023 to December 2025 were randomly divided into three groups: Control Group 1 (30 cases, azacitidine alone), Control Group 2 (30 cases, azacitidine plus low-dose cytarabine), and Observation Group (30 cases, venetoclax combined with azacitidine and low-dose cytarabine). The clinical efficacy was compared among the three groups. Results: The Observation Group showed a significantly higher overall response rate (ORR) and significantly higher overall survival (OS) than the two control groups (p<0.05). There was no significant difference in the incidence of adverse reactions among the three groups (p>0.05). Conclusion: The triple regimen of venetoclax plus demethylating agent and low-dose cytarabine is significantly superior to monotherapy or dual therapy in elderly patients with intermediate- or high-risk MDS. It can markedly improve the response rate and survival rate without increasing adverse reactions, indicating acceptable and controllable safety.