Zhu Jun-Feng, Dai Hai-Ping, Zhang Qian-Qian, Yin Jia, Li Zheng, Cui Qin-Ya, Tian Xiao-Peng, Liu Si-Ning, Jin Zheng-Ming, Zhu Xia-Ming, Wu De-Pei, Tang Xiao-Wen
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Front Oncol. 2022 Oct 12;12:998884. doi: 10.3389/fonc.2022.998884. eCollection 2022.
The 7 + 3 regimen is the front-line induction chemotherapy in patients with newly diagnosed acute myeloid leukemia, with a response rate of 60-80%. But it's not suitable for all patients especially old/unfit patients because of a higher treatment related toxicity. Therefore, safer and more effective induction therapies are required. In this retrospective study, 50 patients with newly diagnosed acute myeloid leukemia received decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) as induction chemotherapy. Complete remission (CR) rate was 96% (48/50) and overall response rate was 100%. Of note, All 7 patients harboring mutation achieved CR. The median overall survival (OS) was 40.0 months (range 2.0, 58.0). The OS at 1, 3, and 5 years were 75.3%, 54.2%, and 49.3%. The median relapse free survival (RFS) was 38.0 months (range 2.0, 58.0). The RFS at 1, 3, and 5 years were 67.3%, 48.9%, and 45.1%. The OS and RFS of patients who received hematopoietic stem cell transplantation (HSCT) were significantly higher than those who did not undergo HSCT (=0.017; 0.016). The incidence of grade 3-4 neutropenia and thrombocytopenia was 84% and 88%. Meanwhile, the incidence of grade 3-4 infection and bleeding was only 16% and 6%. There was no early death. In conclusion, DAC+HAAG regimen is effective and well-tolerated as induction therapy in patients with newly diagnosed AML.
7 + 3方案是新诊断急性髓系白血病患者的一线诱导化疗方案，缓解率为60 - 80%。但由于治疗相关毒性较高，它并不适用于所有患者，尤其是老年/身体状况不佳的患者。因此，需要更安全、更有效的诱导治疗方法。在这项回顾性研究中，50例新诊断的急性髓系白血病患者接受了地西他滨联合HAAG（高三尖杉酯碱、阿克拉霉素、小剂量阿糖胞苷和粒细胞集落刺激因子）作为诱导化疗。完全缓解（CR）率为96%（48/50），总缓解率为100%。值得注意的是，所有7例携带 突变的患者均达到CR。中位总生存期（OS）为40.0个月（范围2.0，58.0）。1年、3年和5年的OS分别为75.3%、54.2%和49.3%。中位无复发生存期（RFS）为38.0个月（范围2.0，58.0）。1年、3年和5年的RFS分别为67.3%、48.9%和45.1%。接受造血干细胞移植（HSCT）的患者的OS和RFS显著高于未接受HSCT的患者（=0.017；0.016）。3 - 4级中性粒细胞减少和血小板减少的发生率分别为84%和88%。同时，3 - 4级感染和出血的发生率仅为16%和6%。无早期死亡。总之，DAC + HAAG方案作为新诊断AML患者的诱导治疗有效且耐受性良好。
