Comparison of VA (Venetoclax, Azacitidine), VACl (VA, Cladribine), VACh (VA, Chidamide), and Alternating VACl/VACh in Newly Diagnosed Acute Myeloid Leukemia

This study compares four different treatment combinations for older adults or those who are not fit enough for intensive chemotherapy who have newly diagnosed acute myeloid leukemia (AML) — a fast-growing blood cancer. The combinations all build on venetoclax plus azacitidine (the current standard), and test whether adding cladribine or chidamide (or alternating between them) improves outcomes. **You may be eligible if...** - You are 18 or older with a confirmed new diagnosis of AML - You are 60 or older, OR under 60 but not suitable for intensive chemotherapy, OR you refused intensive chemotherapy - You have adequate liver and kidney function - Your ECOG performance status is 2 or less (you can care for yourself) - You have a life expectancy of at least 12 weeks **You may NOT be eligible if...** - You have previously received AML treatment (except emergency stabilization with hydroxyurea or a very small dose of cytarabine) - You have certain other prior cancers that are not in remission - You are pregnant or of childbearing potential and not using contraception - You have significant organ problems like severe liver disease Talk to your doctor to see if this trial is right for you.