Analysis Of Efficacy And Safety Of CHID Regimen In Newly Diagnosed Elderly Patients With Acute Myeloid Leukemia

Objective:To explore the efficacy and safety of induction therapy with CHID(low dose cytarabine,darubicin,Homoharringtonine,Granulocyte colonystimulating factor (G-CSF))regimen in elderly patients with acute myeloid leukemia(AML),To provide clinical basis for the choice of treatment regimen in elderly patients with acute myeloid leukemia.Methods:Using a retrospective analysis,The clinical data of 54 newly diagnosed patients with acute myeloid leukemia from September 2013 to December 2018 in Jiangxi people's Hospital were collected.According to the initial treatment induction scheme,they were divided into two groups: CHID group and IA(darubicin combined with cytarabine)group.There were 34 elderly patients with acute myeloid leukemia in the CHID regimen group and 20 patients with acute myeloid leukemia aged 50 to 60years(including 50 and 60 years old)in the IA regimen group.According to the risk grading of cytogenetic / molecular genetic markers,they were further divided into three groups: good prognosis group,medium prognosis group and poor prognosis group.The clinical efficacy and incidence of adverse events were compared between the two groups.Results:Among the 34 patients in the CHID protocol group,13 of them were CR and the total CR rate(including complete response CR and complete response with incomplete complete remission(CRi)was 38.2%,each of the risk stratification's CR rate was 28.6%(2/7),53.8%(7/13)and 28.6%(4/14),In the 20 IA regimen patients,11 of them were CR and the total CR rate was 55%.each of the risk stratification's CR rate was 0%(0/3),72.7%(8/11)and 50%(3/6),There was no statistical significance between the two groups in the total CR rate and each risk stratification(P> 0.05).ORR in CHID group(88.2%)was higher than that in IA group(65%)(P=0.041).There was no significant difference in CR rate between 60-year-old and ?65-year-old patients with CHID regimen group and IA group.Adverse reactions in both groups included hematological side effects(granulopenia,anemia,thrombocytopenia,granulation with fever),Gastrointestinal and pulmonary infection,cardiopulmonary function impairment,during which the incidence of Grade 2-3cardiotoxicity was higher in the IA group,and the difference was conspicuous(P=0.043).And the time of neutropenia and thrombocytopenia in CHID group was longer than that in the IA group.There was no statistical significance between the two groups(P>0.05)as well as in anemia,granulation and fever between the two groups(P>0.05).And neither in the two groups of red blood cells and platelet transfusions(P > 0.05).The above-mentioned haematological and non-hematologic adverse reactions can be tolerated after symptomatic treatment.Conclusion:1.The therapeutic effect of CHID regimen on induction therapy in elderly patients with acute myeloid leukemia is equivalent to that of IA regimen in the treatment of patients with acute myeloid leukemia between 50 years old and 60 years old.It can be used as another choice of induction regimen in elderly patients with acute myeloid leukemia.2.The cardiotoxicity of CHID regimen is much lower than that of traditional IA regimen,It can be used as the first choice of induction chemotherapy for the treatment of acute myeloid leukemia(AML)patients with heart-based diseases.