Meta Analysis Of Azacitidine And Decitabine In Efficacy And Safety In Newly Diagnosed Elderly Patients With Acute Myeloid Leukemia

Objective: Elderly patients with acute myeloid leukemia(AML)have a variety of unfavorable prognostic factors,which are not well tolerated by standard chemotherapy regimens,and low dose cytarabinecan not achieve satisfactory results.Demethylation drugs have certain curative effect on elderly patients with AML.Therefore,we focused on the safety and efficacy of azacitidine and decitabine in elderly patients with AML.Methods: We included 6 randomized controlled study,1379 AML patients were included.in the azacitidinegroup(AG),azacitidine group: traditional regimen group(TRG)=322:492;In the decitabine group(DG),decitabine group: traditional regimen group=284:281.Revman 5.3 software was used for data extraction and statistical analysis.Results: There is a significant advantage of overall survival(OS)in AG compared with the TRG(HR=0.78;95%CI,0.65-0.94)(P=0.007);OS also increased significantly in DG than in TRG,(HR,0.82;95%CI,0.69-0.98)(P=0.03),In complete remission(CR)rate comparison,There is no significant difference between AG and TRG.(RR,0.86;95%CI,0.49-1.50)(P=0.59);But,CR was significantly increased in DG than TRG(HR,2.63;95%CI(1.74-3.97)P<0.00001).The incidence of grade III/IV neutropenia,febrile neutropenia in DG increased significantly compared with TRG(P<0.05);But other adverse effects including III/IV grade anemia,neutropenia,thrombocytopenia,pneumonia and hypokalemia showed no significant difference in DG/AG compared with TRG.Conclusion: OS can be extended in elderly patients with AML using azacitidine or decitabine compared with patients using traditional regimen,and decitabine can significantly improve the patients' rate of CR.The adverse reactions of both demethylation drugs were tolerable.