Clinical Efficacy of CAG Regimen Combined with Venetoclax,Chidamide,and Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia
10.19746/j.cnki.issn1009-2137.2025.04.003
- VernacularTitle:CAG方案联合维奈克拉、西达本胺、阿扎胞苷治疗老年急性髓系白血病的临床疗效观察
- Author:
Qing-Yang LIU
1
;
Yu JING
;
Meng LI
;
Sai HUANG
;
Yu-Chen LIU
;
Ya-Nan WEN
;
Jing-Jing YANG
;
Wen-Jing GAO
;
Ning LE
;
Yi-Fan JIAO
;
Xia-Wei ZHANG
;
Li-Ping DOU
Author Information
1. 解放军医学院;中国人民解放军总医院第五医学中心血液病医学部,北京 100853
- Publication Type:Journal Article
- Keywords:
acute myeloid leukemia;
elderly patients;
venetoclax;
chidamide;
azacitidine
- From:
Journal of Experimental Hematology
2025;33(4):945-950
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and adverse reactions of CAG regimen combined with venetoclax,chidamide,and azacitidine in the treatment of elderly patients with acute myeloid leukemia(AML).Methods:15 elderly AML patients aged ≥ 60 years old who were admitted to the Hematology Department of our hospital from May 2022 to October 2023 were treated with the CAG regimen combined with venetoclax,chidamide and azacitidine,and the efficacy,treatment-related adverse events,overall survival(OS)and event-free survival(EFS)were analyzed.Results:After one course of treatment,11 out of 15 patients achieved complete response(CR),3 patients achieved CR with incomplete hematologic recovery(CRi),and 1 patient died due to prior infection before efficacy evaluation,and the overall response rate(ORR)was 93.3％(14/15).The median follow-up time was 131(19-275)days,with median OS and EFS both remaining unreached.Next-generation sequencing(NGS)analysis showed that among the 15 patients,13 were detected with gene mutations,and there were 7 genes with mutation frequencies of more than 10％,including ASXL1(4 cases),RUNX1(4 cases),BCOR(3 cases),DNMT3A(3 cases),STAG2(2 cases),IDH1/2(2 cases),and TET(2 cases).Among the 13 patients with detectable mutations,12 patients achieved composite response(CR+CRi).The average recovery time of white blood cell count was 14.6 days after chemotherapy,and the average recovery time of platelets was 7.7 days after chemotherapy.The main adverse event was myelosuppression,with 10 patients accompanied by infection.Except for 1 patient who died due to septic shock during chemotherapy,no patients experienced serious complications such as heart,liver,or kidney damage during the treatment process.Conclusion:The CACAG+V regimen,which combines the CAG regimen with venetoclax,chidamide,and azacitidine,can be applied in the treatment of elderly AML patients,demonstrating good safety and induction remission rate.
