He Jingsong, Li Li, Zhu Jingjing, Zheng Weiyan, Wu Wenjun, Zheng Yanlong, Ye Xiujin
Department of Hematology, The First Affiliated Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Bone Marrow Transplant Center, The First Affiliated Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Oncol Lett. 2017 Dec;14(6):7597-7607. doi: 10.3892/ol.2017.7084. Epub 2017 Sep 27.
The current study investigated the efficacy and safety of a novel treatment regime consisting of homobarringtonie, cytosine arabinoside and etoposide (HCE) for the treatment of primary acute myeloid leukemia (AML). In the present study, 141 patients diagnosed with AML were divided into the HCE (n=47) and the conventional AML therapy, consisting of idamycin combined with cytarabine (IA; n=94), treatment groups. The measured patient outcome parameters were the emission and response rates, as well as medication-induced adverse events, with a median follow-up time of 28 months. There was no significant difference in the 3-year relapse-free survival rate between the HCE and IA treatment groups. The occurrence and severity of hematological or non-hematological toxicity did not differ between the two groups. However, of the 26 patients that demonstrated a poor response to the IA treatment, 19 cases were administered the HCE treatment and 14 of these patients achieved complete remission (CR). Of the 10 patients that demonstrated a poor response to the HCE treatment, 8 patients were administered the IA treatment and 7 of these achieved CR. Therefore, HCE may be an effective treatment regimen for patients with primary AML. As there was no cross-resistance between the HCE and IA regimens, HCE may be an alternative option for patients that respond poorly to IA induction therapy.
本研究调查了由高石蒜碱、阿糖胞苷和依托泊苷(HCE)组成的新型治疗方案治疗原发性急性髓系白血病(AML)的疗效和安全性。在本研究中,141例诊断为AML的患者被分为HCE治疗组(n = 47)和传统AML治疗组,后者由伊达比星联合阿糖胞苷(IA;n = 94)组成。测量的患者结局参数为缓解率和反应率,以及药物引起的不良事件,中位随访时间为28个月。HCE组和IA组的3年无复发生存率无显著差异。两组血液学或非血液学毒性的发生率和严重程度无差异。然而,在26例对IA治疗反应不佳的患者中,19例接受了HCE治疗,其中14例患者达到完全缓解(CR)。在10例对HCE治疗反应不佳的患者中,8例接受了IA治疗,其中7例达到CR。因此,HCE可能是原发性AML患者的一种有效治疗方案。由于HCE和IA方案之间不存在交叉耐药性,HCE可能是对IA诱导治疗反应不佳患者的一种替代选择。