Liu Jing, Liu Xiaohong, Jia Jinsong, Gong Lizhong, Lu Shengye, Wang Jing, Huang Xiao-Jun, Jiang Hao
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Peking University, Beijing, China.
Leuk Res Rep. 2022 Oct 19;18:100354. doi: 10.1016/j.lrr.2022.100354. eCollection 2022.
Patients with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) are insensitive to conventional chemotherapy and, therefore, have a poor prognosis. To evaluate the clinical efficacy and safety of low-dose decitabine in combination with small-dose CAG regimen (D-CAG regimen) in treating AML-MRC, a total of 80 patients with newly diagnosed AML-MRC from September 2015 to January 2020 in our center were included in the study. Amongst these patients, 43 and 37 patients received two courses of the D-CAG and CAG regimens, respectively. The complete remission (CR) and complete remission with incomplete blood count recovery (CRi) rate in the D-CAG group was higher than that of the CAG group (62.2% vs. 48.8%, P = 0.013). Among patients with less than 9 months of myelodysplastic syndrome (MDS) history and poor karyotypes, the (CR+CRi) rate of the D-CAG group was statistically higher than that of the CAG group. Except for patients receiving hematopoietic cell transplantation, among patients with less than 9 months of MDS history, the D-CAG group showed a better probability of overall survival than the CAG group did. In conclusion, patients with AML-MRC may benefit from the D-CAG regimen as an induction therapy, especially patients with less than 9 months of MDS history or with poor karyotypes.
伴有骨髓增生异常相关改变的急性髓系白血病（AML-MRC）患者对传统化疗不敏感，因此预后较差。为评估低剂量地西他滨联合小剂量CAG方案（D-CAG方案）治疗AML-MRC的临床疗效和安全性，本研究纳入了2015年9月至2020年1月在我院新诊断的80例AML-MRC患者。其中，43例和37例患者分别接受了两个疗程的D-CAG方案和CAG方案治疗。D-CAG组的完全缓解（CR）率和血细胞计数未完全恢复的完全缓解（CRi）率高于CAG组（62.2%对48.8%，P = 0.013）。在骨髓增生异常综合征（MDS）病史少于9个月且核型不良的患者中，D-CAG组的（CR+CRi）率在统计学上高于CAG组。除接受造血细胞移植的患者外，在MDS病史少于9个月的患者中，D-CAG组的总生存概率高于CAG组。总之，AML-MRC患者可能从D-CAG方案作为诱导治疗中获益，尤其是MDS病史少于9个月或核型不良的患者。
