›› 2009, Vol. 29 ›› Issue (11): 1355-.

• Original article (Clinical research) • Previous Articles     Next Articles

Outcomes and survival analysis of patients with AML and high risk MDS treated by CAG regimen

NI Bei-wen, CHEN Fang-yuan, HAN Jie-ying, ZHONG Hua, ZHONG Lu, HUANG Hong-hui, SHEN Li-jing, XIAO Fei   

  1. Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
  • Online:2009-11-25 Published:2009-11-24

PDF (PC)

1583

Abstract:

Objective To evaluate the clinical efficacy and adverse effects of CAG regimen in treatment of primary, refractory and relapsed acute myeloid leukemia (AML) and high risk myelodysplastic syndrome (MDS), and analyse the factors influencing long-term survival. Methods Sixty-one patients with AML (primary, n=27; refractory, n=18; relapsed, n=16) and 9 patients with MDS were treated with CAG regimen. Examinations on liver and renal function, electrocardiogram and bone marrow cytology were performed before and after treatment, and adverse effects of CAG were observed. Short-term efficacy was evaluated based on clinical manifestation, peripheral blood and bone marrow cytologic examinations. Patients were followed up, overall survival (OS) and disease free survival (DFS) were analysed, and long-term efficacy of CAG regimen was evaluated. The factors influencing long-term survival were analysed by Log-rank test of survival curve. Results After a course of treatment by CAG regimen, the total effective rate was 71%, and 34 patients (49%) experienced complete remission. The median time of follow-up was 45 months, the median OS was 28 months, and the median DFS was 23 months. Age, level of lactate dehydrogenase (LDH), remission condition after a course of treatment by CAG regimen and adoption of HD-Ara-C regimen as consolidation treatment were influencing factors for OS and DFS. The dominant clinical adverse effects were bone marrow depression, with 13 d as the median duration of agranulocytosis (neutrophil <0.5×109/L) and 9 d as the median duration of thrombocytopenia (platelet<20×109/L). Conclusion CAG regimen may lead to favourable therapeutic effects in treatment of primary, refractory and relapsed AML and high risk MDS, and may yield less adverse effects and better long-term therapeutic effects. Age, level of LDH, remission condition after a course of treatment and adoption of HD-Ara-C regimen as consolidation treatment are dominant influencing factors for survival.

Key words: CAG regimen, myelodysplastic syndrome, acute myeloid leukemia, effect