Comparison of the efficacy of IA and HAD induction regimens in the treatment of patients with newly diagnosed acute myeloid leukemia: a single-center study.
10.3760/cma.j.issn.0253-2727.2022.05.006
- Author:
Cong Xiao ZHANG
1
;
Shao Wei QIU
1
;
Ben Fa GONG
1
;
Xiao Yuan GONG
1
;
Yan LI
1
;
Yun Tao LIU
1
;
Qiu Yun FANG
1
;
Guang Ji ZHANG
1
;
Kai Qi LIU
1
;
Chun Lin ZHOU
1
;
Shu Ning WEI
1
;
Dong LIN
1
;
Bing Cheng LIU
1
;
Ying WANG
1
;
Ying Chang MI
1
;
Hui WEI
1
;
Jian Xiang WANG
1
Author Information
1. State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
- Publication Type:Journal Article
- Keywords:
Antineoplastic combined chemotherapy protocols;
Homoharringtonine;
Idarubicin;
Leukemia, myeloid, acute;
Treatment outcome
- MeSH:
Adolescent;
Adult;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Cytarabine/therapeutic use*;
Daunorubicin/therapeutic use*;
Female;
Homoharringtonine/therapeutic use*;
Humans;
Induction Chemotherapy;
Leukemia, Myeloid, Acute/genetics*;
Male;
Middle Aged;
Nuclear Proteins;
Prognosis;
Remission Induction;
Retrospective Studies;
Young Adult
- From:
Chinese Journal of Hematology
2022;43(5):383-387
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To compare the efficacy of two induction regimens, namely, idarubicin combined with cytarabine (IA) versus the combination of homoharringtonine, daunorubicin, and cytarabine (HAD) , in adult patients with newly diagnosed de novo acute myeloid leukemia (AML) . Methods: From May 2014 to November 2019, 199 patients diagnosed with AML receiving either the IA or HAD regimens were assessed for overall survival (OS) , relapse-free survival (RFS) , as well as the CR rate and the MRD negative rate after induction therapy. The differences in prognosis between the two induction therapy groups was assessed according to factors, including age, white blood cell (WBC) count, NPM1 mutation, FLT3-ITD mutation, 2017 ELN risk stratification, CR(1) transplantation, and the use of high-dose cytarabine during consolidation therapy, etc. Results: Among the 199 patients, there were 104 males and 95 females, with a median age of 37 (15-61) years. Ninety patients received the IA regimen, and 109 received the HAD regimen. Comparing the efficacy of the IA and HAD regimens, the CR rates after the first induction therapy were 71.1% and 63.3%, respectively (P=0.245) , and the MRD negative rates after the first induction therapy were 53.3% and 48.6%, respectively (P=0.509) . One patient in the IA group and two in the HAD group died within 60 days after induction. The two-year OS was 61.5% and 70.6%, respectively (P=0.835) , and the two-year RFS was 51.6% and 57.8%, respectively (P=0.291) . There were no statistically significant differences between the two groups. Multivariate analysis showed that the ELN risk stratification was an independent risk factor in both induction groups; CR(1) HSCT was an independent prognostic factor for OS and RFS in the IA patients and for RFS in the HAD patients but not for OS in the HAD patients. Age, WBC level, NPM1 mutation, and FLT3-ITD mutation had no independent prognostic significance. Conclusion: The IA and HAD regimens were both effective induction regimens for AML patients.
