Comparison of efficacy between high-dose CAG regimen and standard-dose cytarabine regimen for acute myeloid leukemia patients with partial remission after the first course of standard induction chemotherapy

Abstract

Objective To compare the efficacy of high-dose CAG (HD-CAG) regimen by increasing the dose of aclarubicin in conventional CAG regimen and standard-dose cytarabine (SDAC) combination regimen in acute myeloid leukemia (AML) patients with partial remission (PR) after standard induction regimen. Methods This study retrospectively analyzed 49 PR AML patients after 3 days of daunorubicin or idarubicin and 7 days of cytarabine regimen (namely 3+7 ) in the First Affiliated Hospital of Soochow University and Haikou Municipal People's Hospital from October 2006 to September 2015. Based on different reinduction regimen, these patients were divided into 2 groups: HD-CAG (23 cases) and SDAC (26 cases). The clinical characteristics, efficacy, toxicity and survival rate were further evaluated between 2 groups. Results The complete remission (CR) rate in HD-CAG group was higher than that in SDAC group [91.3% (21/23) vs. 65.4% (17/26), P=0.030], while the overall response (OR) rate between 2 groups was not statically different [95.7% (22/23) vs. 84.6% (22/26), P=0.423]. Meanwhile, myelosuppression and infection rate of HD-CAG regimen were similar with SDAC regimen. There were no statistically significant differences in overall survival (OS) and disease free survival (DFS) rates at 12 months between 2 groups (P=0.287, P=0.816). Conclusion The HD-CAG regimen could obtain a better efficacy than SDAC regimen for these AML patients with PR after the first course of standard induction chemotherapy. Key words: Leukemia, myeloid, acute; High-dose CAG regimen; Standard-dose cytarabine; Induction chemotherapy