论著(临床研究)

A phase IV study of homoharringtonine, cytarabine, aclacinomycin and G-CSF (HCAG) regimen compared with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia patients#br#

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  • Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
LIU Zhao(刘钊)(1984—),女,硕士生;电子信箱:sundaylalaliu@hotmail.com。ZHANG Yun-xiang(张赟翔)(1989—),女,博士生;电子信箱: kittyzyx@msn.com。WANG Li-ning(王丽宁)(1988—),女,博士生;电子信箱:manyanjoyce@sina.com。* 为共同第一作者。

网络出版日期: 2017-09-28

基金资助

 National Natural Science Foundation of China(81270621, 81300451); National Public Health Grand Research Foundation(201202003); Shanghai Health System Advanced and Appropriate Technology Promotion Projects(2013SY001); Multiple Clinical Research Center Program of Shanghai Jiao Tong University School of Medicine (DLY201513).

A phase IV study of homoharringtonine, cytarabine, aclacinomycin and G-CSF (HCAG) regimen compared with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia patients

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  • Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Online published: 2017-09-28

Supported by

 National Natural Science Foundation of China(81270621, 81300451); National Public Health Grand Research Foundation(201202003); Shanghai Health System Advanced and Appropriate Technology Promotion Projects(2013SY001); Multiple Clinical Research Center Program of Shanghai Jiao Tong University School of Medicine (DLY201513).

摘要

 Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients.  Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS).  Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification.  Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.

本文引用格式

LIU Zhao*, ZHANG Yun-xiang*, WANG Li-ning*, XIA Zheng, MAO Yuan-fei, ZHAO Hui-ji . A phase IV study of homoharringtonine, cytarabine, aclacinomycin and G-CSF (HCAG) regimen compared with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia patients#br#[J]. 上海交通大学学报(医学版), 2017 , 37(8) : 1100 . DOI: 10.3969/j.issn.1674-8115.2017.08.010

Abstract

 Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients.  Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS).  Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification.  Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.
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