Clinical observation of elderly patients with acute myelogenous leukemia treated with CAG regimen combined with thalidomide

Abstract

Objective To evaluate the clinical efficacy and safety for the CAG regimen combined with thalidomide in elderly patients with acute myelogenous leukemia (AML).Methods 51 untreated elderly cases with AML were randomly divided into treatment group (treated with CAG regimen combined with thalidomide,26 cases) and control group (treated with CAG regimen alone,25 cases),and the clinical efficacy and safety were observed.Results After 2 cycles of treatment,the complete remission (CR) rates of treatment group and control group were 61.5 ％ (16/26) and 48.0 ％ (12/25) respectively,the difference was not significant (P =0.404).With regard to prostecdtive efficacy,the difference was markedly significant,1-year CR rates of treatment group and control group were 53.8 ％(14/26) and 24.0 ％ (6/25) respectively (P =0.045),and 2-year CR rates were 42.3 ％ (11/26) and 12.0 ％ (3/25) respectively (P =0.027).During the follow-up of 2 years,overall 1-and 2-year overall survival rates were 73.1％ and 46.1％ in treatment group versus 52.0 ％ and 24.0 ％ in control group.During the follow-up of 2 years,the estimated mean overall survival time in treatment group was 22 months and it was 13 months in control group (P =0.018).The induction mortality rates and myelosuppression showed no difference between the two groups.Compared with control group,the side effect rate of nausea and vomiting was significantly decreased in treatment group (P =0.025).Conclusion The CAG regimen combined with thalidomide is effective with little side effects for elderly AML,and is worthy of further study and clinic application. Key words: Leukemia, myeloid, acute; Thalidomide; Antineoplastic combined chemotherapy protocols