Decitabine combined with full鄄dose and long鄄term pre鄄excitation regimen for treatment of relapsed/refractory acute myeloid leukemia: a clinical study of 32 cases
10.3760/cma.j.issn.1009_9921.2019.04.007
- VernacularTitle:地西他滨联合足量长疗程预激方案治疗复发难治急性髓系白血病32例临床研究
- Author:
Ying LIU
1
;
Ruihua MI
;
Lin CHEN
;
Qingsong YIN
;
Fangfang YUAN
;
Yuanyuan XIONG
;
Xudong WEI
Author Information
1. 郑州大学附属肿瘤医院 河南省肿瘤医院血液科 450008
- Keywords:
Leukemia,myeloid,acute;
Refractory;
Relapsed;
Decitabine;
Pre_excitation regimen
- From:
Journal of Leukemia & Lymphoma
2019;28(4):223-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical efficacy and adverse events of decitabine combined with full_dose and long_term pre_excitation regimen as a induction therapy for relapsed/refractory acute myeloid leukemia (AML). Methods A total of 32 patients with relapsed/refractory AML in Henan Provincial Cancer Hospital from May 2013 to February 2018 were enrolled. All the patients were treated with decitabine combined with full_dose and long_term pre_excitation regimen, including 15 patients who received decitabine combined with CAG regiemtn, and 17 patients who received decitabine combined with CHAG regimen: 25 mg decitabine, intravenous drip, from day 1 to day 3; cytarabine (10-15 mg/m2) administered subcutaneously every 12 h one time, from day 4 to day 17 or more; homoharringtonine (1 mg/m2) intravenous drip, administered intravenously from day 4 to day 10 or more; aclacinomycin (8-10 mg/m2), intravenous drip, administered intravenously from day 4 to day 11 or more; granulocyte colony_stimulating factor (G_CSF) (100-200 μg/m2), subcutaneous injection, and it began 1 day before chemotherapy, adjusted according to the blood cell count; the therapeutic effect and adverse reactions of the patients were observed. Results There were 29 patients (90.6% ) with complete remission (CR), 3 patients (9.4% ) with partial remission (PR), and the overall response (CR+PR) rate was 100.0% (32/32). In decitabine combined with CAG regimen group, 13 patients achieved CR; in decitabine combined with CHAG regimen group, 16 patients achieved CR, and there was no statistically significant difference in the efficacy between the two groups (P＝0.589). The main adverse reactions were agranulocytosis, thrombocytopenia, secondary infection and fever, and no serious adverse events occurred. Conclusion Decitabine combined with full_dose and long_term pre_excitation regimen has a favorable efficacy and safety, which provides a new therapy for relapsed/refractory AML.
