›› 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).

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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