Efficacy and safety of azacytidine combined with low-dose HAG regimen in treatment of newly diagnosed elderly acute myeloid leukemia patients ineligible for intensive chemotherapy
10.3760/cma.j.cn115356-20220501-00122
- VernacularTitle:阿扎胞苷联合低剂量HAG方案治疗新诊断不适合强化疗老年急性髓系白血病患者的效果及安全性
- Author:
Bingbing WEN
1
;
Sitian YANG
;
Haoyu PENG
;
Weiwen YOU
;
Weihong CHEN
;
Yun CAI
;
Huanxun LIU
;
Xin DU
Author Information
1. 深圳市第二人民医院 深圳大学第一附属医院血液内科，深圳 518035
- Keywords:
Leukemia, myeloid, acute;
Azacitidine;
HAG regiment;
Aged;
Treatment outcome
- From:
Journal of Leukemia & Lymphoma
2022;31(10):583-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of azacitidine combined with HAG regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy.Methods:Eighteen newly diagnosed elderly AML patients ineligible for intensive chemotherapy from July 2019 to September 2021 in the Second People's Hospital of Shenzhen were prospectively enrolled in this study. They were non-randomly divided into azacitidine combined with HAG regimen (AZA-HAG) group (9 cases) and decitabine combined with HAG regimen (DEC-HAG) group (9 cases). The primary endpoint of the study was overall response [complete remission (CR)+partial remission], and the secondary endpoints included CR + complete remission with incomplete count recovery (CRi), overall survival (OS) and drug safety. Kaplan-Meier method was used to analyze the OS.Results:The median age of 18 patients was 67 years old (60-77 years old) , and 8 of them were in high-risk group. After one course of treatment, the overall response and CR+CRi were observed in 7 of 9 patients in AZA-HAG group, and they were observed in 8 of 9 patients in DEC-HAG group, and there was no significant difference between the two groups (both P = 1.000). The median duration of CR+CRi was 7 months in both groups, and the median OS time was 12 months in both groups; there was no significant difference in OS between the two groups ( χ2 = 0.02, P = 0.895). In AZA-HAG group, 1 patient with TP53 mutation and 1 patient with ASXL1+RUNX1 mutation acquired CR, and 1 patient with NPM1 wild-type combined with FLT3-ITD and ASXL1 mutation did not respond. There was no significant difference in the incidence of grade 3-4 hematological adverse reactions between the two groups (all P < 0.05). Conclusions:Azacitidine combined with low-dose HAG regimen in the treatment of newly diagnosed elderly AML patients ineligible for intensive chemotherapy has satisfactory efficacy and long-term survival, and the adverse reactions can be tolerated.
