Effect observation of low-dose idarubicin or reduced homoharringtonine combined with cytarabine for the treatment of de novo patients with acute myeloid leukemia

Abstract

Objective To compare the efficacy and adverse effects of low-dose idarubicin (IDA) or low-dose homoharringtonine (HHT) combined with cytarabine (Ara-C) for the treatment of de novo patients with acute myeloid leukemia (AML). Methods De novo AML patients (except for the acute promyelocytic leukemia) treated with low-dose IDA combined with Ara-C (low-dose IA group) or low-dose HHT combined with Ara-C (low-dose HA group) as initial induction from 1st, January, 2013 to 30th, June, 2015 were retrospectively analyzed, and their efficacy and adverse reactions were compared. Results 46 of 67 patients in the low-dose IA group reached complete remission (CR), meanwhile there were 8 of 20 patients in the low-dose HA group reached CR after two courses of induction treatment. The CR rate of IA regimen was 68.7 % , which was significantly higher than that of HA regimen (40.0 %) (χ2= 5.372, P= 0.020). The overall response rates of low-dose IA group and HA group were 77.6 % (52/67) and 60.0 % (12/20) respectively, and there was no significant difference between the two groups (P > 0.05). Both the hematological and non-hematological adverse effects were observed and no difference was found in the two groups, neither in myelosuppression,the major hematological adverse effects, nor in non-hematological adverse effects (all P > 0.05), except for the median duration of absolute neutrophil count < 1×109/L (Z=-3.023, P= 0.003). Conclusion With more serious adverse effects, the CR rate after two induction chemotherapy courses of low-dose IA regimen is higher than that of low-dose HA regimen in de novo AML patients. Key words: Leukemia, myeloid, acute; Idarubicin; Homoharringtonine; Cytarabine