The Meta-analysis Of Efficacy And Safety Evaluation Of Decitabine Combined With CAG Regimen In The Treatment Of Elderly Acute Myeloid Leukemia

Objiectives:To systematically evaluate the efficacy and safety of decitabine(DCA)combined with CAG regimen in the treatment of elderly acute myeloid leukemia(AML).Methods:The electronic retrieval system was used to search the CNKI database,VIP database,Wanfang database,PubMed database,and Web of Science database,referring to published randomized controlled trials of the comparison of DCA combined with CAG regimen and CAG regimen alone in the efficacy and safety for elderly acute myeloid leukemia from 2015 to 2020.The literature was screened according to the criteria for literature inclusion,and relevant data were collected after literature quality assessment.Reviewmanager version 5.3 software was used for Meta analysis to evaluate the complete response rate(CR),effective rate(CR+PR)and incidence of adverse reactions of the two groups.Results:A total of 28 articles were included in this study,all articles are RCT study.A total of 1920 cases of elderly leukemia patients were included,958 cases in the decitabine combined CAG group and 962 cases in the CAG group.Meta analysis results shown that the complete remission rate and effective rate of decitabine combined with CAG group in the treatment of elderly acute myeloid leukemia was higher than that of CAG group,the difference was statistically significant,the relative risk ratio and 95% confidence interval of complete remission rate is 1.73(1.54 ~1.96);the relative risk ratio and 95% confidence interval of effective rate is 1.44(1.36 ~ 1.54).Among the adverse reactions,the difference of the incidence of thrombocytopenia is statistically significant,the relative risk ratio and its 95%confidence interval is 2.38(1.72 ~ 3.30),other adverse reactions such as: lung infection,fever,nausea,vomiting,diarrhea,abnormal liver function,heart damage,andhair loss have no statistically significant difference,the relative risk ratio and its 95%confidence interval are 1.01(0.68~1.49),0.77(0.39~1.52),0.97(0.65~1.45),1.26(0.87~1.83),1.11(0.76~1.64),0.83(0.43~1.63),1.41(0.98~2.04)respectively.Conclusion:(1)Compared with the CAG regimen alone,the complete remission rate and effective rate of decitabine combined with CAG regimen in the treatment of elderly acute myeloid leukemia are higher.(2)Compared with the CAG regimen alone,thrombocytopenia adverse reaction of decitabine combined with CAG regimen is higher.