IAG Regimen For Patients With Refractory And Relapsed Acute Leukemia

Part Ⅰ：IAG Regimen For Patients With Refractory and RelapsedAcute Myeloid LeukemiaObjective:To evaluate the clinical efficacy of IAG regimen for patients with refractory andrelapsed acute myeloid leukemia(AML).Methods:26patients with refractory and relapsed AML were treated with IAG regimencomposed by idarubicin10mg/d intravenously daily, day1-8, Ara-C10mg/m2subcutaneously once every12hours，day1-14，and G-CSF200μg/m2subcutaneouslydaily，day0-14. the response and severe adverse effects were evaluated retrospectively.Comparison of the rate of two samples using Fisher exact test.30patients with refractory and relapsed AML treated with CAG regimen in the sameperiod were collected as a control group, the differences of efficacy, safety and prognosiswere evaluated retrospectively.Results:17patients (65.4%) achieved complete remission (CR),2patients (7.7%) got partialremission (PR),7patients (26.9%) were not remission (NR), the overall effective rate(CR+PR) was73.1%. Low CR rate in the patients with MDS history, but there were nosignificant difference in subsets of age, count of WBC at diagnosis, number ofchemotherapies and cytogenetic.1of these26patients suffered septic shock,2sufferedpulmonary fungal infections. There was no significant difference between IAG and CAG regimen in the CR rate,but the disease-free survival after IAG regimen was longer than CAG regimen.Conclusion:IAG regimen was effective and safe as reinducing chemotherapy for patients withrefractory and relapsed AML.It deserved further study. Part Ⅱ：IAG Regimen For Patients With Refractory and Relapsed Acutelymphoblastic LeukemiaObjective:To evaluate the clinical efficacy of IAG regimen for patients with refractory andrelapsed acute lymphoblastic leukemia(ALL).Methods:13patients with refractory and relapsed ALL were treated with IAG regimencomposed by idarubicin10mg/d intravenously daily, day1-8, Ara-C10mg/m2subcutaneously once every12hours，day1-14，and G-CSF200μg/m2subcutaneouslydaily，day0-14. the response and severe adverse effects were evaluated retrospectively.16patients with refractory and relapsed ALL treated with CAG regimen in the sameperiod were collected as a control group, the differences of efficacy, safety and prognosiswere evaluated retrospectively.Results:（1）7patients (53.8%) achieved complete remission (CR),2patients (15.4%) gotpartial remission (PR),4patients (30.8%) were not remission (NR). The10-3level ofminimal residual disease (MRD) was detected in Only one CR case,and the remaining sixCR cases of MRD were10-4level.（2）Neutropenia and thrombocytopenia were happened in all patients. Seven patientshad infectious fever, including two cases of pulmonary infection,and case12died of lung infection. One patient had abnormal liver function, two cases of patients withgastrointestinal reactions.（3）There were no significant differences between IAG and CAG regimen in the CRrate, DFS and overall survival（OS）.Conclusion:IAG regimen was effective and safe as reinducing chemotherapy for patients withrefractory and relapsed ALL.It deserved further study.