Objective:To investigate the efficacy of azacitidine combined with CAG regimen in the treatment of acute myeloid leukemia (AML) patients who are not suitable for intensive chemotherapy.Methods:A retrospective case-series study was conducted. A total of 67 AML patients with newly diagnosed elderly, treatment-related secondary and myelodysplastic syndromes or myeloproliterative neoplasms primary transformation who were not suitable for intensive chemotherapy were selected from Heze Municipal Hospital from January 2020 to December 2023. Azacitidine combined with CAG regimen was given for treatment, and the efficacy and adverse reactions of the patients were observed.Results:Among the 67 patients, there were 32 females and 35 males with the median age [ M ( Q1, Q3)] of 68 (65, 72) years old. There were 40 cases in the high-risk group, 13 cases in the medium-risk group, and 14 cases in the low-risk group. After 1 course of treatment with azacitidine combined with CAG regimen, the overall response rate (ORR) was 38.8% (26/67), with a complete remission (CR) rate of 20.9% (14/67), a complete remission rate with incomplete recovery of blood cell count (CRi) of 11.9% (8/67), and a partial remission (PR) rate of 6.0% (4/67). After 4 courses of treatment, the ORR was 59.7% (40/67), with a CR rate of 56.7% (38/67) and a CRi rate of 3.0% (2/67). There were no PR patients. All patients in the low-risk and medium risk groups achieved at least CRi, while the ORR in the high-risk group was 40.0% (16/40). There was a statistically significant difference in efficacy between different risk groups ( P < 0.001). The patient had mild adverse reactions, mainly pain and grade 1-2 hematological adverse reactions. Conclusions:AML patients who are intolerant to intensive chometherapy are effectively treated with azacitidine combined with CAG regimen, and the adverse reactions are mild.

Objective:To investigate the clinical efficacy and safety of domestic bortezomib in the treatment of patients with multiple myeloma (MM).Methods:The data of 60 MM patients treated with domestic bortezomib as the basic chemotherapy regimen in 5 medical centers of Qilu Hospital of Shandong University, Heze Municipal Hospital, Weifang People's Hospital, Binzhou Medical University Hospital, Zibo Central Hospital in Shandong Province from January 2018 to June 2019 were retrospectively analyzed, 52 of which were newly treated patients and 8 were relapsed and refractory patients. The patients received at least 2 courses of combined chemotherapy based on domestic bortezomib, and the efficacy was assessed and evaluated every 2 courses.Results:Follow-up until June 30, 2019 showed that some patients were unable to return to the hospital for regular treatment. All patients completed at least 2 courses of treatment, with an overall effective rate (ORR) of 76.7% (46/60); 42 patients completed 4 courses of treatment, with an ORR of 78.6% (33/42); 30 patients completed 6 courses of treatment, with an ORR of 86.7% (26/30); there was no significant difference in ORR of 2, 4 and 6 courses ( P > 0.05). The complete remission+very good partial remission rates of 2, 4 and 6 courses were 16.7% (10/60), 47.6% (20/42) and 66.7% (20/30), respectively, and the difference was statistically significant ( P < 0.01). During the treatment, the adverse events mainly included infection, peripheral neuropathy, herpes, digestive tract symptoms, hematologic toxicities and so on, which were light and moderate mostly, and most of them can be reversed. The total incidence of adverse events in patients who completed 2, 4 and 6 courses of treatment were 91.7% (55/60), 66.7% (28/42) and 36.7% (11/30), respectively. Conclusions:The domestic bortezomib-based chemotherapy regimens have good efficacy in the treatment of MM. The incidence of adverse events is similar to that of the original drug, and patients can tolerate the adverse events.