Abstract
The regimen of cytarabine, aclarubicin and G-CSF (CAG) has been widely used in China and Japan for treatment of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). We searched literature on CAG between 1995 and 2010 and performed a meta-analysis to determine its overall efficacy using a random-effects or fixed-effects model. Thirty five trials with a total of 1029 AML (n = 814) and MDS (n = 215) patients were included for analysis. The CR rate of AML (57.9%) was significantly higher than that of MDS (45.7%) (p < 0.01). No difference in CR was noted between the new (56.7%) and relapsed/refractory AML (60.1%) (p > 0.05). The CR rate was also significantly higher in patients with favorable (64.5%) and intermediate (69.6%) karyotypes than those with unfavorable one (29.5%) (p < 0.05). Remarkably, the CR rate of CAG was significantly higher than those of non-CAG regimens (odds ratio 2.43). CAG regimen was well tolerated, with cardiotoxicity in 2.3% and early death in 5.2% of the cases. In conclusion, CAG regimen was an effective and safe regimen for the treatment of AML, and may be more effective than non-CAG regimens. Randomized controlled trials are strongly recommended to evaluate its efficacy and safety in comparison with the current standard treatment.
Highlights
Intensive chemotherapy can achieve complete remission (CR) in 60% - 80% of patients with newly diagnosed de novo acute myeloid leukemia (AML) [1,2]
Transformed from myelodysplastic syndrome (MDS) (MDS/t-AML) patients, numbers of patients in CR were extracted from individual studies and CR rates were recalculated from the derived data
CR was defined using the criteria developed by an International Working Group [21]
Summary
Intensive chemotherapy can achieve complete remission (CR) in 60% - 80% of patients with newly diagnosed de novo acute myeloid leukemia (AML) [1,2]. Http://www.jhoonline.org/content/4/1/46 low-dose Ara-C and G-CSF can lead to preferential killing of CFU-AML [16]; (3) Aclarubicin is effective regardless of multi-drug resistance gene status [17]; (4). We performed a systematic review and meta-analysis to assess the overall treatment efficacy and the adverse events of the CAG regimen. Eligible studies were relevant clinical trials on AML and MDS patients treated with CAG regimen. For subgroup analysis of patients with newly diagnosed, refractory/relapsed AML, and MDS or AML transformed from MDS (MDS/t-AML) patients, numbers of patients in CR were extracted from individual studies and CR rates were recalculated from the derived data. For each meta-analysis, the Cochrane’s Q statistic was first calculated to assess the heterogeneity of the included studies. All the statistical analyses were done by GW and DL
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
