›› 2017, Vol. 37 ›› Issue (8): 1100-.doi: 10.3969/j.issn.1674-8115.2017.08.010

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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

LIU Zhao*, ZHANG Yun-xiang*, WANG Li-ning*, XIA Zheng, MAO Yuan-fei, ZHAO Hui-jin, YOU Jian-hua,  YU Yang, ZHAO Yu-bing, REN Yu-hong, LI Ya, WANG Yan, CHEN Qiu-sheng, LI Jun-min#, CHEN Yu#   

  1. Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2017-08-28 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).

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.

Key words: homoharringtonine, long-term survival, risk factors, acute myeloid leukemia, elderly patient