Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia
The 7 + 3 regimen is the front-line induction chemotherapy in patients with newly diagnosed acute myeloid leukemia, with a response rate of 60-80%. But it’s not suitable for all patients especially old/unfit patients because of a higher treatment related toxicity. Therefore, safer and more effective...
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| Format: | Article |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.998884/full |
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| author | Jun-Feng Zhu Jun-Feng Zhu Jun-Feng Zhu Hai-Ping Dai Hai-Ping Dai Qian-Qian Zhang Qian-Qian Zhang Jia Yin Jia Yin Zheng Li Zheng Li Qin-Ya Cui Qin-Ya Cui Xiao-Peng Tian Xiao-Peng Tian Si-Ning Liu Si-Ning Liu Zheng-Ming Jin Zheng-Ming Jin Xia-Ming Zhu Xia-Ming Zhu De-Pei Wu De-Pei Wu Xiao-Wen Tang Xiao-Wen Tang |
| author_facet | Jun-Feng Zhu Jun-Feng Zhu Jun-Feng Zhu Hai-Ping Dai Hai-Ping Dai Qian-Qian Zhang Qian-Qian Zhang Jia Yin Jia Yin Zheng Li Zheng Li Qin-Ya Cui Qin-Ya Cui Xiao-Peng Tian Xiao-Peng Tian Si-Ning Liu Si-Ning Liu Zheng-Ming Jin Zheng-Ming Jin Xia-Ming Zhu Xia-Ming Zhu De-Pei Wu De-Pei Wu Xiao-Wen Tang Xiao-Wen Tang |
| author_sort | Jun-Feng Zhu |
| collection | DOAJ |
| description | The 7 + 3 regimen is the front-line induction chemotherapy in patients with newly diagnosed acute myeloid leukemia, with a response rate of 60-80%. But it’s not suitable for all patients especially old/unfit patients because of a higher treatment related toxicity. Therefore, safer and more effective induction therapies are required. In this retrospective study, 50 patients with newly diagnosed acute myeloid leukemia received decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) as induction chemotherapy. Complete remission (CR) rate was 96% (48/50) and overall response rate was 100%. Of note, All 7 patients harboring FLT3-ITD mutation achieved CR. The median overall survival (OS) was 40.0 months (range 2.0, 58.0). The OS at 1, 3, and 5 years were 75.3%, 54.2%, and 49.3%. The median relapse free survival (RFS) was 38.0 months (range 2.0, 58.0). The RFS at 1, 3, and 5 years were 67.3%, 48.9%, and 45.1%. The OS and RFS of patients who received hematopoietic stem cell transplantation (HSCT) were significantly higher than those who did not undergo HSCT (p=0.017; 0.016). The incidence of grade 3-4 neutropenia and thrombocytopenia was 84% and 88%. Meanwhile, the incidence of grade 3-4 infection and bleeding was only 16% and 6%. There was no early death. In conclusion, DAC+HAAG regimen is effective and well-tolerated as induction therapy in patients with newly diagnosed AML. |
| first_indexed | 2024-04-11T17:22:08Z |
| format | Article |
| id | doaj.art-349468afec0d4f94a54f37c30d9f4fb3 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T17:22:08Z |
| publishDate | 2022-10-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-349468afec0d4f94a54f37c30d9f4fb32022-12-22T04:12:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.998884998884Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemiaJun-Feng Zhu0Jun-Feng Zhu1Jun-Feng Zhu2Hai-Ping Dai3Hai-Ping Dai4Qian-Qian Zhang5Qian-Qian Zhang6Jia Yin7Jia Yin8Zheng Li9Zheng Li10Qin-Ya Cui11Qin-Ya Cui12Xiao-Peng Tian13Xiao-Peng Tian14Si-Ning Liu15Si-Ning Liu16Zheng-Ming Jin17Zheng-Ming Jin18Xia-Ming Zhu19Xia-Ming Zhu20De-Pei Wu21De-Pei Wu22Xiao-Wen Tang23Xiao-Wen Tang24National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaDepartment of Hematology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaNational Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaInstitute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, ChinaThe 7 + 3 regimen is the front-line induction chemotherapy in patients with newly diagnosed acute myeloid leukemia, with a response rate of 60-80%. But it’s not suitable for all patients especially old/unfit patients because of a higher treatment related toxicity. Therefore, safer and more effective induction therapies are required. In this retrospective study, 50 patients with newly diagnosed acute myeloid leukemia received decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) as induction chemotherapy. Complete remission (CR) rate was 96% (48/50) and overall response rate was 100%. Of note, All 7 patients harboring FLT3-ITD mutation achieved CR. The median overall survival (OS) was 40.0 months (range 2.0, 58.0). The OS at 1, 3, and 5 years were 75.3%, 54.2%, and 49.3%. The median relapse free survival (RFS) was 38.0 months (range 2.0, 58.0). The RFS at 1, 3, and 5 years were 67.3%, 48.9%, and 45.1%. The OS and RFS of patients who received hematopoietic stem cell transplantation (HSCT) were significantly higher than those who did not undergo HSCT (p=0.017; 0.016). The incidence of grade 3-4 neutropenia and thrombocytopenia was 84% and 88%. Meanwhile, the incidence of grade 3-4 infection and bleeding was only 16% and 6%. There was no early death. In conclusion, DAC+HAAG regimen is effective and well-tolerated as induction therapy in patients with newly diagnosed AML.https://www.frontiersin.org/articles/10.3389/fonc.2022.998884/fullinduction chemotherapydecitabineHAAGacute myeloid leukemiaefficacy and safety |
| spellingShingle | Jun-Feng Zhu Jun-Feng Zhu Jun-Feng Zhu Hai-Ping Dai Hai-Ping Dai Qian-Qian Zhang Qian-Qian Zhang Jia Yin Jia Yin Zheng Li Zheng Li Qin-Ya Cui Qin-Ya Cui Xiao-Peng Tian Xiao-Peng Tian Si-Ning Liu Si-Ning Liu Zheng-Ming Jin Zheng-Ming Jin Xia-Ming Zhu Xia-Ming Zhu De-Pei Wu De-Pei Wu Xiao-Wen Tang Xiao-Wen Tang Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia Frontiers in Oncology induction chemotherapy decitabine HAAG acute myeloid leukemia efficacy and safety |
| title | Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia |
| title_full | Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia |
| title_fullStr | Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia |
| title_full_unstemmed | Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia |
| title_short | Efficacy and safety of decitabine combined with HAAG (homoharringtonine, aclarubicin, low-dose cytarabine and G-CSF) for newly diagnosed acute myeloid leukemia |
| title_sort | efficacy and safety of decitabine combined with haag homoharringtonine aclarubicin low dose cytarabine and g csf for newly diagnosed acute myeloid leukemia |
| topic | induction chemotherapy decitabine HAAG acute myeloid leukemia efficacy and safety |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.998884/full |
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