Efficacy observation of standard-dose IA regimen in treatment of ≥ 55 years old newly diagnosed patients with acute myeloid leukemia

Abstract

Objective To explore the clinical efficacy and toxicity of standard-dose IA regimen as induction chemotherapy in treating initially diagnosed acute myeloid leukemia (AML) patients ≥ 55 years old. Methods A total of 32 patients were enrolled in this study. The remission, survival time and adverse effects after IA regimen were retrospectively analyzed. Results The complete remission (CR) rate, partial remission (PR) rate and overall response (OR) rate were 71.9% (23/32), 9.4% (3/32), 81.3% (26/32) after IA regimen. In favorable, intermediate and poor prognosis groups (grouped by cytogenetic or molecular factors), 6, 14 and 3 cases achieved CR (χ 2= 5.571, P= 0.067), 1, 2 and 0 cases achieved PR, while OR rates were 100.0% (7/7),84.2% (16/19), 50.0% (3/6) (χ 2= 2.114, P= 0.359). The median overall survival (OS) time of three groups were 28.07 months (6.57-46.33 months), 16.93 months (0.40-87.57 months) and 3.03 months (2.00-6.00 months) (Z= 9.630, P= 0.008) and the 2-year OS rates were 83.33%, 46.80% and 0, respectively (χ2= 12.206, P < 0.001). Myelosuppression and infections due to neutropenia were the main adverse effects and severe non-hemotologic toxicities were not observed. Conclusion The standard-dose IA regimen can increase CR/OR rate and prolong the median OS time of patients with favorable and intermediate prognosis and it can be used as the first induction chemotherapy regimen for elderly AML patients of ≥ 55 years old. Key words: Leukemia, myeloid, acute; Idarubicin; Cytarabine; Induction chemotherapy