Abstract:

Objective To explore the efficacy and safety of re⁃induction regimen of decitabine in combina⁃ tion with CAG for patients with acute myeloid leukemia after failed standard induction chemotherapy in the first course. Methods Eighty⁃four patients with failed standard induction chemotherapy in the first course included in the study were divided equally into three groups：DCAG，IA3+7，and IDCB，treated with the regimens of DAC combined with CAG，IA（3+7）and Intermediate⁃dose Ara⁃C⁃based chemotherapy（IDCB）including IA3+3 and CLAG，respectively. After re⁃induction therapy，the clinical efficacy and adverse reactions were compared among the 3 groups. Results No significant difference in the complete remission（CR）was found between the three groups （P = 0.091），but the rates of overall response（OR）（complete remission（CR）and partial remission（PR））in the DCAG group was significantly higher than the IDCB group（P = 0.049）. The median duration of thrombocytopenia in the DCAG group was significantly shorter than IA3+7 and IDCB groups（P = 0.001；P = 0.023）. No significant difference in the median time of neutropenia was found among the 3 groups（P = 0.061）. The incidence rates of lung infection and febrile neutropenia in the DCAG group were significantly lower than the IA3+7 group（P = 0.018； P = 0.004）. The 2⁃year OS of the DCAG，IA3+7 and IDCB groups was 69.4%，43.8% and 33.2%，respectively， and the 2⁃year RFS was 70.6%，50.3% and 41.4%，respectively. The OS and RFS of DCAG were significantly longer than the IA3+7 and IDCB groups（P = 0.038 and P = 0.023 for OS；P = 0.016 and P = 0.048 for RFS）. Conclusions DCAG regimen may represent a better alternative option with good response and safety for AML patients failing in the first course of standard induction chemotherapy.

Key words:

acute myeloid leukemia, re?induction regimen, efficacy, safety