DECITABINE COMBINED WITH HAAG AS INDUCTION CHEMOTHERAPY FOR NEWLY DIAGNOSED ACUTE MYELOID LEUKEMIA
(Abstract release date: 05/19/16)
EHA Library. Tang X. 06/09/16; 132485; E936
Prof. Dr. Xiaowen Tang
Contributions
Contributions
Abstract
Abstract: E936
Type: Eposter Presentation
Background
Treatment of newly diagnosed acute myeloid leukemia (AML) remains challenging. Several host- and disease-related factors contribute to poor outcome in elderly patients or high risk patients with AML, including medical comorbidities, physical frailty, and increased incidence of poor-risk biologic features. Indicating an urgent need for alternative treatment strategies improving clinical outcome for these patients. It is confirmed that Decitabine has the synergistic reaction with daunomycin or cytarabine. Therefore, we investigated whether Decitabine combined with HAAG regimen might also be effective for the newly diagnosed of AML patients.
Aims
To evaluate the efficacy and toxicity of DAC combined with HAAG regimen as an induction therapy for newly diagnosed AML patients as well as compared with standard IA(IDA 12mg/m2/d*3d) regimen.
Methods
130 patients with AML were newly diagnosed in our center bewteen January 2014 and December 2015.The median age was 42（11-82）years. Among them,49 cases received DAC+HAAG regimen(DAC 20mg/m2/d*5d combined with low dose of homoharringtonine 1mg/m2/d*7-14d, cytarabine subcutaneously 10mg/m2/q12h*7-14d, aclarubicin 10mg/d*4-8d and G-CSF priming). The other 81 patients received standard IA regimen (idarubicin 12mg/m2/d*3d and cytarabine 100mg/m2/d*7d).The outcomes of all the patients after one cycle of chemotherapy were evaluated.
Results
1.The complete remission(CR) rate of DAC+HAAG group was superior than that of IA group(81.6% vs 74.5%, P=0.517), but with no statistically significant. While the overall response rate (ORR) of DAC+HAAG group was similar wiht IA group(87.8% vs 88.7%, P=0.786). 2. Median overall survival (OS) from the starting of DAC+HAAG chemotherapy and IA were 6.5(2-20) months and 8.5(0.5-25) months (P=0.384). Meanwhile, the estimated one-year survival of DAC+HAAG and IA group were 55.8%±8.9 and 77.9%±5.4% respectively (P=0.089).3. The survival of DAC+HAAG were not more prior than IA, but we found that the ages of DAC+HAAG were statistically older than the IA group(P=0.00). However, in DAC+HAAG group, there were 14 elderly (≥60 years old) that not any one in IA group(P=0.000). The CR rate of the old cases was 64.3% and the estimated 1-year survival was 73.4%±13.4%. 4. Treatment related mortality (TRM) was found in 1 case in DAC+HAAG group compared with 2 cases in IA group. All patients presented cytopenias of grade 4. There were no differences on the recovery time of ANC ≥0.5*109/L,HB≥70g/L and PLT≥20*109/L after induction chemotherapy (P=0.969,0.392,0.225). 5. The incidence of adverse events including fever, nausea and vomiting, diarrhea were lower in DAC+HAAG group(P=0.024,0.024 and 0.028). While the happened of infection,bleeding,cardiovascular impact, liver dysfunction and renal insufficiency were similar. 6.For the two group, lower blast percentage as diagnosed were significantly associated with a higher OS rate (P=0.000 and P=0.000).
Conclusion
DAC+HAAG regimen as an induction chemotherapy for newly diagnosed AML patients could better effectively reduce tumor burden than IA regimen(no statistical significance) with mild toxicity. For naïve AML patients, DAC combined with HAAG regimen may be an optimal choice, especially for patients who cannot tolerate high dose of chemotherapy.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Decitabine, Induction chemotherapy
Type: Eposter Presentation
Background
Treatment of newly diagnosed acute myeloid leukemia (AML) remains challenging. Several host- and disease-related factors contribute to poor outcome in elderly patients or high risk patients with AML, including medical comorbidities, physical frailty, and increased incidence of poor-risk biologic features. Indicating an urgent need for alternative treatment strategies improving clinical outcome for these patients. It is confirmed that Decitabine has the synergistic reaction with daunomycin or cytarabine. Therefore, we investigated whether Decitabine combined with HAAG regimen might also be effective for the newly diagnosed of AML patients.
Aims
To evaluate the efficacy and toxicity of DAC combined with HAAG regimen as an induction therapy for newly diagnosed AML patients as well as compared with standard IA(IDA 12mg/m2/d*3d) regimen.
Methods
130 patients with AML were newly diagnosed in our center bewteen January 2014 and December 2015.The median age was 42（11-82）years. Among them,49 cases received DAC+HAAG regimen(DAC 20mg/m2/d*5d combined with low dose of homoharringtonine 1mg/m2/d*7-14d, cytarabine subcutaneously 10mg/m2/q12h*7-14d, aclarubicin 10mg/d*4-8d and G-CSF priming). The other 81 patients received standard IA regimen (idarubicin 12mg/m2/d*3d and cytarabine 100mg/m2/d*7d).The outcomes of all the patients after one cycle of chemotherapy were evaluated.
Results
1.The complete remission(CR) rate of DAC+HAAG group was superior than that of IA group(81.6% vs 74.5%, P=0.517), but with no statistically significant. While the overall response rate (ORR) of DAC+HAAG group was similar wiht IA group(87.8% vs 88.7%, P=0.786). 2. Median overall survival (OS) from the starting of DAC+HAAG chemotherapy and IA were 6.5(2-20) months and 8.5(0.5-25) months (P=0.384). Meanwhile, the estimated one-year survival of DAC+HAAG and IA group were 55.8%±8.9 and 77.9%±5.4% respectively (P=0.089).3. The survival of DAC+HAAG were not more prior than IA, but we found that the ages of DAC+HAAG were statistically older than the IA group(P=0.00). However, in DAC+HAAG group, there were 14 elderly (≥60 years old) that not any one in IA group(P=0.000). The CR rate of the old cases was 64.3% and the estimated 1-year survival was 73.4%±13.4%. 4. Treatment related mortality (TRM) was found in 1 case in DAC+HAAG group compared with 2 cases in IA group. All patients presented cytopenias of grade 4. There were no differences on the recovery time of ANC ≥0.5*109/L,HB≥70g/L and PLT≥20*109/L after induction chemotherapy (P=0.969,0.392,0.225). 5. The incidence of adverse events including fever, nausea and vomiting, diarrhea were lower in DAC+HAAG group(P=0.024,0.024 and 0.028). While the happened of infection,bleeding,cardiovascular impact, liver dysfunction and renal insufficiency were similar. 6.For the two group, lower blast percentage as diagnosed were significantly associated with a higher OS rate (P=0.000 and P=0.000).
Conclusion
DAC+HAAG regimen as an induction chemotherapy for newly diagnosed AML patients could better effectively reduce tumor burden than IA regimen(no statistical significance) with mild toxicity. For naïve AML patients, DAC combined with HAAG regimen may be an optimal choice, especially for patients who cannot tolerate high dose of chemotherapy.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Decitabine, Induction chemotherapy
Abstract: E936
Type: Eposter Presentation
Background
Treatment of newly diagnosed acute myeloid leukemia (AML) remains challenging. Several host- and disease-related factors contribute to poor outcome in elderly patients or high risk patients with AML, including medical comorbidities, physical frailty, and increased incidence of poor-risk biologic features. Indicating an urgent need for alternative treatment strategies improving clinical outcome for these patients. It is confirmed that Decitabine has the synergistic reaction with daunomycin or cytarabine. Therefore, we investigated whether Decitabine combined with HAAG regimen might also be effective for the newly diagnosed of AML patients.
Aims
To evaluate the efficacy and toxicity of DAC combined with HAAG regimen as an induction therapy for newly diagnosed AML patients as well as compared with standard IA(IDA 12mg/m2/d*3d) regimen.
Methods
130 patients with AML were newly diagnosed in our center bewteen January 2014 and December 2015.The median age was 42（11-82）years. Among them,49 cases received DAC+HAAG regimen(DAC 20mg/m2/d*5d combined with low dose of homoharringtonine 1mg/m2/d*7-14d, cytarabine subcutaneously 10mg/m2/q12h*7-14d, aclarubicin 10mg/d*4-8d and G-CSF priming). The other 81 patients received standard IA regimen (idarubicin 12mg/m2/d*3d and cytarabine 100mg/m2/d*7d).The outcomes of all the patients after one cycle of chemotherapy were evaluated.
Results
1.The complete remission(CR) rate of DAC+HAAG group was superior than that of IA group(81.6% vs 74.5%, P=0.517), but with no statistically significant. While the overall response rate (ORR) of DAC+HAAG group was similar wiht IA group(87.8% vs 88.7%, P=0.786). 2. Median overall survival (OS) from the starting of DAC+HAAG chemotherapy and IA were 6.5(2-20) months and 8.5(0.5-25) months (P=0.384). Meanwhile, the estimated one-year survival of DAC+HAAG and IA group were 55.8%±8.9 and 77.9%±5.4% respectively (P=0.089).3. The survival of DAC+HAAG were not more prior than IA, but we found that the ages of DAC+HAAG were statistically older than the IA group(P=0.00). However, in DAC+HAAG group, there were 14 elderly (≥60 years old) that not any one in IA group(P=0.000). The CR rate of the old cases was 64.3% and the estimated 1-year survival was 73.4%±13.4%. 4. Treatment related mortality (TRM) was found in 1 case in DAC+HAAG group compared with 2 cases in IA group. All patients presented cytopenias of grade 4. There were no differences on the recovery time of ANC ≥0.5*109/L,HB≥70g/L and PLT≥20*109/L after induction chemotherapy (P=0.969,0.392,0.225). 5. The incidence of adverse events including fever, nausea and vomiting, diarrhea were lower in DAC+HAAG group(P=0.024,0.024 and 0.028). While the happened of infection,bleeding,cardiovascular impact, liver dysfunction and renal insufficiency were similar. 6.For the two group, lower blast percentage as diagnosed were significantly associated with a higher OS rate (P=0.000 and P=0.000).
Conclusion
DAC+HAAG regimen as an induction chemotherapy for newly diagnosed AML patients could better effectively reduce tumor burden than IA regimen(no statistical significance) with mild toxicity. For naïve AML patients, DAC combined with HAAG regimen may be an optimal choice, especially for patients who cannot tolerate high dose of chemotherapy.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Decitabine, Induction chemotherapy
Type: Eposter Presentation
Background
Treatment of newly diagnosed acute myeloid leukemia (AML) remains challenging. Several host- and disease-related factors contribute to poor outcome in elderly patients or high risk patients with AML, including medical comorbidities, physical frailty, and increased incidence of poor-risk biologic features. Indicating an urgent need for alternative treatment strategies improving clinical outcome for these patients. It is confirmed that Decitabine has the synergistic reaction with daunomycin or cytarabine. Therefore, we investigated whether Decitabine combined with HAAG regimen might also be effective for the newly diagnosed of AML patients.
Aims
To evaluate the efficacy and toxicity of DAC combined with HAAG regimen as an induction therapy for newly diagnosed AML patients as well as compared with standard IA(IDA 12mg/m2/d*3d) regimen.
Methods
130 patients with AML were newly diagnosed in our center bewteen January 2014 and December 2015.The median age was 42（11-82）years. Among them,49 cases received DAC+HAAG regimen(DAC 20mg/m2/d*5d combined with low dose of homoharringtonine 1mg/m2/d*7-14d, cytarabine subcutaneously 10mg/m2/q12h*7-14d, aclarubicin 10mg/d*4-8d and G-CSF priming). The other 81 patients received standard IA regimen (idarubicin 12mg/m2/d*3d and cytarabine 100mg/m2/d*7d).The outcomes of all the patients after one cycle of chemotherapy were evaluated.
Results
1.The complete remission(CR) rate of DAC+HAAG group was superior than that of IA group(81.6% vs 74.5%, P=0.517), but with no statistically significant. While the overall response rate (ORR) of DAC+HAAG group was similar wiht IA group(87.8% vs 88.7%, P=0.786). 2. Median overall survival (OS) from the starting of DAC+HAAG chemotherapy and IA were 6.5(2-20) months and 8.5(0.5-25) months (P=0.384). Meanwhile, the estimated one-year survival of DAC+HAAG and IA group were 55.8%±8.9 and 77.9%±5.4% respectively (P=0.089).3. The survival of DAC+HAAG were not more prior than IA, but we found that the ages of DAC+HAAG were statistically older than the IA group(P=0.00). However, in DAC+HAAG group, there were 14 elderly (≥60 years old) that not any one in IA group(P=0.000). The CR rate of the old cases was 64.3% and the estimated 1-year survival was 73.4%±13.4%. 4. Treatment related mortality (TRM) was found in 1 case in DAC+HAAG group compared with 2 cases in IA group. All patients presented cytopenias of grade 4. There were no differences on the recovery time of ANC ≥0.5*109/L,HB≥70g/L and PLT≥20*109/L after induction chemotherapy (P=0.969,0.392,0.225). 5. The incidence of adverse events including fever, nausea and vomiting, diarrhea were lower in DAC+HAAG group(P=0.024,0.024 and 0.028). While the happened of infection,bleeding,cardiovascular impact, liver dysfunction and renal insufficiency were similar. 6.For the two group, lower blast percentage as diagnosed were significantly associated with a higher OS rate (P=0.000 and P=0.000).
Conclusion
DAC+HAAG regimen as an induction chemotherapy for newly diagnosed AML patients could better effectively reduce tumor burden than IA regimen(no statistical significance) with mild toxicity. For naïve AML patients, DAC combined with HAAG regimen may be an optimal choice, especially for patients who cannot tolerate high dose of chemotherapy.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Decitabine, Induction chemotherapy
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