The Clinical Efficacy And Safety Between Decitabine Combined With CAG Regimen And IA Regimen Inptreatment Of Newly Diagnosed Elderly Patients With Acute Myeloid Leukemia

ObjectiveTo compare the clinical efficacy and safety between decitabine combined with DAG regimen and IA regimen(3+7) in treatment of newly diagnosed elderly patients with acute myeloid leukemia(non APL).MethodsThe clinical data of 61 AML old patients enrolled from August 2010 to January 2016 first treated with decitabine combined with CAG regimen or IA regimen were collected. Patients were stratified by age, PS, cytogenetic/molecular risk, leukocyte level,Antecedent hematologic disorder into three stratifications, including Favorable-risk, Intermediate-risk,Poor-risk. The rate of stratification in D+CAG regimen and IA regimen is 20.0% VS 19.5%,40.0%VS 36.6%,40.0% VS 43.9%, respectively. And no significant difference was observed between the two groups (P=0.163). The differences of clinical outcome and adverse events between the two groups were analyzed.Results20 patients treated with D+CAG regimen and 41 patients with IA regimen. The composite complete remission (CRc), included complete remission (CR) and complete remission with incomplete hematologic recovery (CRi). In favorable-risk of D+CAG group,75%(3/4) patients achieved CRc; Among 8 patients in Intermediate-risk, 62.5%(5/8) patients achieved CRc; Among 8 patients in poor-risk,37.5%(3/8)patients achieved CRc;the CRc rate of three stratifications above is 55.0%(11/20). Among 8 patients in favorable-risk of IA group,75%(6/8)patients achieved CRc; Among 15 patients in Intermediate-risk,66.7%(10/15) patients achieved CRc; Among 18 patients in poor-risk,38.9%(7/18)achieved CRc.The total CRc of three stratifications above is 56.1%(23/41). The CRc between the two groups showed no significant difference. The difference of adverse events in the two groups, mainly including myelosuppression, pulmonary infection, liver dysfunction, heart and renal dysfunction, were not significant except thrombocytopenia(P=0.014), and could be tolerated. Followed-up to January 2016, the overall survival of 1 year between the two groups showed no significant difference.ConclusionsDecitabine combined with CAG regimen is effictive in newly diagnosed elderly patients with acute myeloid leukemia compared to IA regimen.Although the incidence of the toxicities of thrombocytopenia in D+CAG regimen is higher than IA regimen,the other common toxicities between the two groups show no significant difference. Hence, D+CAG regimen appeared to be a feasible, safe and effective for elderly patients with AML.