Treatment in Middle and High Risk Myelodysplastic Syndrome and Acute Myeloid Leukemia

Abstract

Objective To investigate the clinical efficacy and adverse reactions of the CIG regimen,which composed of cytosine arabinoside (AraC),idarubicin (IDA) and granulocyte colony-stimulating factor (G-CSF),in middle and high risk myelodysplastic syndrome (MDS),previously untreated elderly acute myeloid leukemia (AML),refractory AML/relapsed AML and secondary AML from MDS patients.Methods From April 2004 to March 2010,40 patients who were in line with the study inclusion criteria and exclusion criteria were included into this study.By the method of randomized controlled trial,they were randomly divided into research group (n=16) and control group (n=18).The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the Tenth People's Hospital,Tongji University.The CIG regimen was used to treat 3 cases of MDS and 13 cases of AML patients in research group.The mitoxantrone and AraC (MA regimen) were used to treat 2 cases of AML from MDA and 16 cases of AML patients.The outcomes of each group were evaluated after 1 course of treatment.The patients with treatment failure were exited from the trial and the responders continued to receive another course of treatment.All patients were followed up,and overall survival (OS) were analyzed.Results In treatment group,9 cases achieved complete remission (CR),4 cases achieved partial remission (PR). The total responsive rate was 81.25％.6 cases were CR after the first course,3 cases were PR after the second course.The median OS was 26 months.In control group,8 cases achieved CR,and 4 cases achieved PR.The total responsive rate was 66.67 ％.4 cases were CR after the first course,and 2 cases were PR after the second course.The median OS was 20 months.Conclusions Treatment for middle and high risk MDS and unfavourable prognosis AML with CIG regiment is safe and effective.Long-term outcome need to be observed further. Key words: myelodysplastic syndrome; acute myeloid leukemia; scheme