Zhao Hongyu, Xu Li, Yang Yongjian, Shao Jianhua, Chen Ping, Dong Xuebin, Gu Linping, Li Daqi
Department of Hematology, Jinan Central Hospital, Jinan, China.
Acta Haematol. 2017;137(4):195-200. doi: 10.1159/000464013. Epub 2017 Apr 27.
To investigate the safety and efficacy of the triple therapy of decitabine, idarubicin, and cytarabine in the treatment of refractory or recurrent acute myeloid leukemia (R/R AML).
We conducted a single-center retrospective study in which decitabine treatment was administered prior to full-dose idarubicin and cytarabine (D-IA) for 21 R/R AML patients.
After 1 cycle of D-IA, 10/21 (47.6%) patients experienced a complete remission (CR) and 2/21 (9.5%) showed a partial response. There was a 1-month response rate (RR) in 12/21 patients (57.14%); these patients achieved CR after 2 cycles of D-IA. Five of these 12 (40%) patients then received sequential allogeneic stem cell transplantation. At the last follow-up date, 9/21 (42.8%) patients had survived, and 7/21 (33.3%) were in continuous CR. Hematological toxicity and infections were the most prominent toxicities of this regimen. Other toxicities included nausea, vomiting, bleeding, and liver enzyme abnormalities. No mortalities were recorded due to treatment-related toxicity during remission.
The combination was well tolerated, and the RR was encouraging. Our study suggests that D-IA may offer a novel and potentially effective treatment regimen for R/R AML patients.
探讨地西他滨、伊达比星和阿糖胞苷三联疗法治疗难治性或复发性急性髓系白血病（R/R AML）的安全性和有效性。
我们进行了一项单中心回顾性研究，对21例R/R AML患者在给予全剂量伊达比星和阿糖胞苷（IA）之前先给予地西他滨治疗（D-IA）。
1个周期的D-IA治疗后，10/21（47.6%）例患者获得完全缓解（CR），2/21（9.5%）例患者显示部分缓解。12/21例患者（57.14%）有1个月的缓解率（RR）；这些患者在2个周期的D-IA治疗后达到CR。这12例患者中有5例（40%）随后接受了异基因造血干细胞移植。在最后随访日期，9/21（42.8%）例患者存活，7/21（33.3%）例患者持续处于CR状态。血液学毒性和感染是该方案最突出的毒性。其他毒性包括恶心、呕吐、出血和肝酶异常。缓解期间未记录到因治疗相关毒性导致的死亡病例。
该联合方案耐受性良好，缓解率令人鼓舞。我们的研究表明，D-IA可能为R/R AML患者提供一种新的、潜在有效的治疗方案。
