Abstract
Objective. The present study aimed at investigating the efficacy and safety of intravenous administration of cytarabine supplemented with idarubicin in treating acute myeloid leukemia (AML) patients undergoing first attack and its effects on serum levels of cell adhesion molecules, cytokines in response to inflammation, and T cell subset populations in acute myeloid leukemia (AML) patients undergoing first attack. Methods. A total of 88 AML patients eligible for inclusion and exclusion criteria participated in the study and were randomly assigned into the control group (n = 44) in which the patients received intravenous administration of cytarabine and daunorubicin and the study group (n = 44) in which the patients received intravenous administration of cytarabine and idarubicin. Clinical response, incidence of adverse reactions, and quality of life 3 months after therapy were evaluated. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), IL-10, and IL-35 were measured by ELISA methods. Phenotypic characteristics of T cell subsets including CD4+, CD8+, CD4+IL-10 Tregs, and CD4+CD25+CD127−Foxp3+ Tregs were analyzed by flow cytometry. Results. The clinical response rate of the study group was better than that of the control group (65.91% vs. 45.45%) ( P < 0.05 ). After treatment, the study group revealed significantly lower levels of sICAM-1, sVCAM-1, IL-10, and IL-35, a lower proportion of Tregs, a higher rate of CD4+/CD8+ T cells, along with increased scores of the Karnofsky Performance Scale (KPS) compared with the control group ( P < 0.05 ). The incidence rate of adverse reactions in the study group was lower than that in the control group (34.09% vs. 61.36%) ( P < 0.05 ). Conclusion. These findings demonstrate that intravenous administration of cytarabine supplemented with idarubicin can improve the immune function and quality of life of AML patients, and this combination drug therapy is effective and safe for AML.
Highlights
Acute leukemia is classified into acute myeloid leukemia (AML) and acute lymphocytic leukemia according to the presence of different damaged cells [1]
Chemotherapy regimens of cytarabine with daunorubicin or idarubicin are the standard treatment for AML patients [19]. e purpose of this study is to investigate the changes in serum concentrations of soluble Vascular cell adhesion molecule-1 (VCAM-1), soluble intercellular adhesion molecule-1 (ICAM-1), interleukin 10 (IL-10), and IL-35 along with T cell subsets including CD4+, CD8+, CD4+IL-10 Tregs, and CD4+CD25+CD127−Foxp3+ Tregs in the newly diagnosed AML patients receiving intravenous administration of cytarabine and idarubicin
Intravenous Administration of Cytarabine and Idarubicin Declined Levels of soluble ICAM-1 (sICAM-1), soluble VCAM-1 (sVCAM-1), IL-10, and IL-35 in AML Patients. e levels of sICAM-1, sVCAM-1, IL-10, and IL-35 were measured by Enzyme-Linked Immunosorbent Assay (ELISA) of serum samples. e results revealed that serum levels of sICAM-1, sVCAM-1, IL-10, and IL-35 were declined significantly in AML patients following intravenous administration of cytarabine supplemented with either idarubicin or daunorubicin (P < 0.05), and this decrease was more evident in AML patients following intravenous administration of cytarabine supplemented with idarubicin (P < 0.05, Figure 1)
Summary
Acute leukemia is classified into acute myeloid leukemia (AML) and acute lymphocytic leukemia according to the presence of different damaged cells [1]. AML is a malignant clonal disease characterized by changes in normal hematopoietic cells, leading to the proliferation of immature progenitor cells and inhibition of cell differentiation. Immature progenitor cells spread through blood to various parts of the body [2]. AML is commonly seen in adults, especially for these diagnosed at a median age of 68 years, accounting for up to 80% of acute leukemia [3]. AML incidence is positively correlated with age. It was reported about 1.3 cases out of 100 thousand people had the disease and the age was below 65 years old, and 12.2 cases, who aged over 65 years, out of 100 thousand people were subject to the disease [4]. The progress of AML treatment is beneficial to significant improvement in the prognosis of young patients, AML is associated with variable prognosis and high mortality. e 5-year overall survival was 40–50%
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