Yazarlar : Chen C, Xu W, Yang J et al

Yayın : Leuk Lymphoma

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/low-dose-homoharringtonine-and-cytarabine-combination-granulocyte-colony-stimulating-factor-elderly-?tsid=5

Konu : Geriyatrik Hematoloji

Literatür İçeriği :  Abstract The treatment of a young patient with acute myeloid leukemia (AML) has improved dramatically during the past several decades. However, management for elderly patients with AML still remains a challenge. HCG (homoharringtonine and cytarabine in combination with granulocyte colony-stimulating factor) regimen has shown promise for elderly patients with AML transformed from myelodysplastic syndrome (MDS). To our knowledge, the clinical effect of HCG regimen for elderly de novo AML patients has not been well evaluated. A total of 56 elderly de novo AML patients aged 60-80 years were enrolled in this study. All patients were treated with HCG regimen. The overall response rate was 75% (60.7%% CR and 14.3% PR). 14 (25%) of the 56 patients showed no response (NR). A higher CR rate was observed in patients aged<70 years, with better-risk or intermediate-risk karyotype and with NPM1 mutations. Effects of several factors on the treatment CR rate to HCG including sex, initial leukocyte count, percent of blast in bone marrow, performance status and gene mutations (FLT3-ITD, CEBPA and DNMT3A) were not statistically different. To the date of the last follow-up, the median overall survival (OS) was 12.0±1.7 months. There were significant correlations of OS with age, initial karyotype, performance status and gene mutations (NPM1, FLT3-ITD and DNMT3A) at diagnosis, but not with presenting sex, initial leukocyte count, percent of blast in bone marrow and CEBPA mutations. The early death (ED) rate was 7.1%. Hematologic toxicity was well tolerated; severe nonhematologic toxicity was not observed. Our data suggest that low-dose homoharringtonine and cytarabine in combination with granulocyte colony-stimulating factor priming regimen is safe and effective for elderly de novo AML patients.

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