Analysis Of Therapeutic Effects And Safety Of Azacitidine Combined With HAG Regimen In Elderly Patients With AML And MDS

Objective To investigate the therapeutic effects of azacitidine combined with HAG regimen on elderly patients with acute myeloid leukemia(AML)and myelodysplastic syndrome(MDS),and to evaluate its safety.Methods According to the national criteria of domestic diagnosis and treatment guidelines,41 elderly patients with acute myeloid leukemia and myelodysplastic syndrome were included.Among them,25 elderly patients with acute myeloid leukemia were randomly divided into AZA-HAG group and DAC-HAG group,with 13 cases in AZA-HAG group and 12 cases in DAC-HAG group.The patients in AZA-HAG group were treated with azacytidine 75 mg / m~2,subcutaneous injection,once a day,D1-7;Combined HAG regimen: homoharringtonine 1mg /(m~2 · d),intravenous drip,once a day,d1-14;Cytarabine 10 mg /(m~2 · d),subcutaneous injection,Q12 H,D1-14;Granulocyte colony stimulating factor 200 ug /(m~2 · d),subcutaneous injection,D 0-14;28 days was a course of treatment.In the DAC-HAG group,azacytidine was replaced by decitabine(10 mg / m~2 · d),intravenous drip,once a day,D1-5,combined with HAG regimen.The 16 patients with MDS were treated with AZA-HAG regimen.The overall response rate(ORR)and complete remission rate(CR)of 41 patients after treatment were observed,and the adverse reactions of all patients were observed.The follow-up events were from July 2019 to February 2021.Spss25.0 software was used for statistical analysis,and nonparametric order and test were used for comparison between groups.p < 0.05 was statistically significant.Results The ORR and CR of azacytidine combined with HAG regimen in 29 elderly patients with AML and MDS were 86.20% and 75.86%,respectively.The ORR and CR of 13 elderly patients with AML and 16 patients with MDS were 84.61%,76.92% and 87.50%,75.00%,respectively.There was no significant difference in ORR and CR between primary or secondary AML patients,better prognosis group or poor prognosis group,M5 or non M5,and patients over 70 years old or ≤ 70 years old(P >0.05).And there was no significant difference in the ORR and CR between the two groups(P > 0.05).There was no significant difference in ORR and CR between AZAHAG group and DAC-HAG group(P > 0.05).The main adverse reaction of AZAHAG regimen was myelosuppression,but the incidence was low(59.1%),and one patient was early death(3.44%).Conclusion Azacytidine combined with HAG regimen can significantly improve the remission rate of elderly patients with acute myeloid leukemia and myelodysplastic syndrome,with less adverse reactions and better tolerance.