Abstract
Background and purposeThe response to remission induction in elderly patients with acute myeloid leukemia (AML) remains poor. The purpose of this paper is to evaluate the efficacy and toxicity of a plant alkaloid, homoharringtonine, in combination with cytarabine as an induction therapy for AML in elderly patients (≥60 years).ResultsTwenty-three patients were treated with the HA regimen consisting of homoharringtonine (2 mg/m2/day for 7 days) and cytarabine (Ara-C, 100 mg/m2/day for 7 days). The overall response rate was 56.5% with complete remission (CR) rate of 39.1% and partial remission of 17.4%. There was no early death in this cohort of patients. The estimated median overall survival (OS) time of all patients was (12.0 ± 3.0) months. The estimated OS time of the CR patients was 15 months. The estimated one-year OS rate of all patients treated with HA protocol was (49.3 ± 13.5) %. The estimated one-year OS rate of the CR patients was (62.5 ± 17.1) %.ConclusionHA is a suitable induction regimen for elderly patients with AML, with relatively low toxicity and reasonable response rate.
Highlights
The standard induction remission protocol in the treatment of acute myeloid leukemia (AML) in adult patients is 3-day daunorubicin (DNR) and 7-day cytarabine (AraC) [1]
Over the 25 years in which this protocol has been in use, a considerable number of strategies have been developed with the goal of improving the efficacy of this protocol, including the substitution of alternative anthracyclines such as idarubicin [2,3]
Homoharringtonine (HHT) is a plant alkaloid, derived from the Cephalotuxus fortuneii tree, which for the past 30 years has been used in China for the treatment of AML and chronic myeloid leukemia (CML)
Summary
The standard induction remission protocol in the treatment of acute myeloid leukemia (AML) in adult patients is 3-day daunorubicin (DNR) and 7-day cytarabine (AraC) [1]. The anthracycline-based protocol has a high overall complete remission (CR) rate in the treatment of AML, the outcome in elderly AML patients remains unsatisfactory. Homoharringtonine (HHT) is a plant alkaloid, derived from the Cephalotuxus fortuneii tree, which for the past 30 years has been used in China for the treatment of AML and chronic myeloid leukemia (CML). The response to remission induction in elderly patients with acute myeloid leukemia (AML) remains poor. The purpose of this paper is to evaluate the efficacy and toxicity of a plant alkaloid, homoharringtonine, in combination with cytarabine as an induction therapy for AML in elderly patients (≥60 years)
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