HAG regimen improves survival in adult patients with hypocellular acute myeloid leukemia.
HAG regimen improves survival in adult patients with hypocellular acute myeloid leukemia.
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HAG 方案可提高低细胞急性髓系白血病成年患者的生存率。
DOI：
10.18632/oncotarget.6211
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发表时间：
2016-01-19
期刊：
影响因子：
--
通讯作者：
Song X
中科院分区：
文献类型：
--
作者：
Hu X;Fu W;Wang L;Gao L;Lü S;Xi H;Qiu H;Chen L;Chen J;Ni X;Xu X;Zhang W;Yang J;Wang J;Song X
低细胞性急性髓系白血病（Hypo-AML）是一种罕见疾病。调查低 AML 生物学特征的研究很大程度上缺乏。我们在七年的时间里检查了我们研究所低 AML 的临床和生物学特征以及治疗结果。我们回顾性分析了631例根据法美英（FAB）分类和WHO造血和淋巴组织肿瘤分类诊断的成人AML患者的数据，其中包括43例低AML患者。对低 AML 患者的生物学变量、治疗结果和随访数据进行了分析。在 631 名 AML 患者中，47 名 (7.4%) 被诊断为低 AML，其中 43 名患者可评估。与非低细胞性 AML 相比，低细胞性 AML 患者年龄较大（P = 0.05），更容易出现白细胞减少症（P < 0.01）和前部血液疾病（P = 0.02）。低 AML 患者的总体完全缓解 (CR) 率、无病生存 (DFS) 和总生存 (OS) 与非低 AML 患者相当。 27 名 (62.8%) 低细胞 AML 患者接受蒽环类药物和阿糖胞苷 (XA) 标准方案治疗（相关 CR 率：51.9%；中位 OS：7 个月；中位 DFS：6.5 个月）。 16 名 (37.2%) 患者接受了含有高三尖杉酯碱、阿糖胞苷和 G-CSF (HAG) 的启动方案治疗（相关 CR 率：81.25%；中位 OS：16 个月；中位 DFS：16 个月）。低 AML 的总体预后并不比非低 AML 差。 HAG 方案可能会提高低 AML 患者的缓解率并改善生存率。
Hypocellular acute myeloid leukemia (Hypo-AML) is a rare disease entity. Studies investigating the biological characteristics of hypo-AML have been largely lacking. We examined the clinical and biological characteristics, as well as treatment outcomes of hypo-AML in our institutes over a seven years period. We retrospectively analyzed data on 631 adult AML patients diagnosed according to the French-American-British (FAB) classification and WHO classification of tumors of haematopoietic and lymphoid tissue, including 43 patients with hypo-AML. Biological variables, treatment outcomes and follow-up data on hypo-AML patients were analyzed. Out of 631 AML patients, 47 (7.4%) were diagnosed as hypo-AML, out of which 43 patients were evaluable. Compared with non-hypocellular AML, hypo-AML patients tended to be older (P = 0.05), more likely to present with leukocytopenia (P < 0.01) and anterior hematological diseases (P = 0.02). The overall complete remission (CR) rate, disease free survival (DFS), and overall survival (OS) in hypo-AML patients were comparable to those in non-hypo AML patients. Twenty-seven (62.8%) patients with hypocellular AML were treated with the standard regimen of anthracyclines and cytarabine (XA) (associated CR rate: 51.9%; median OS: 7 months; median DFS: 6.5 months). Sixteen (37.2%) patients were treated with a priming regimen containing homoharringtonine, cytarabine and G-CSF (HAG) (associated CR rate: 81.25%; median OS: 16 months; median DFS: 16 months). The overall prognosis of hypo-AML was not inferior to that of non-hypo AML. HAG regimen might increase response rates and improve survival in hypo-AML patients.