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Decitabine in combination with low-dose cytarabine, aclarubicin and G-CSF tends to improve prognosis in elderly patients with high-risk AML.

Abstract
We evaluated the risk status and survival outcomes of 125 elderly acute myeloid leukemia (AML) patients treated with decitabine in combination with low-dose cytarabine, aclarubicin, and G-CSF (D-CAG). The risk status was evaluated by determining the frequency of recurring gene mutations using next-generation sequencing (NGS) analysis of 23 selected genes and cytogenetic profiling of bone marrow samples at diagnosis. After a median follow-up of 12 months (range: 2-82 months), 86 patients (68.8%) had achieved complete remission after one cycle of induction, and 94 patients (75.2%) had achieved it after two cycles. The median overall survival (OS) and disease-free survival (DFS) were 16 and 12 months, respectively. In 21 AML patients aged above 75 years, the median OS and DFS were longer in the low- and intermediate-risk group than the high-risk group, but the differences were not statistically significant. The median OS and DFS were similar in patients with or without TET2, DNMT3A, IDH2, TP53 and FLT3 mutations. Multivariate analysis showed that patient age above 75 years, high-risk status, and genetic anomalies, like deletions in chromosomes 5 and/or 7, were significant variables in predicting OS. D-CAG regimen tends to improve the prognosis of a subgroup of elderly patients with high-risk AML.
AuthorsMing Hong, Han Zhu, Qian Sun, Yu Zhu, Yi Miao, Hui Yang, Hai-Rong Qiu, Jian-Yong Li, Si-Xuan Qian
JournalAging (Aging (Albany NY)) Vol. 12 Issue 7 Pg. 5792-5811 (04 01 2020) ISSN: 1945-4589 [Electronic] United States
PMID32238611 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Aclarubicin
  • Decitabine
Topics
  • Aclarubicin (therapeutic use)
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Cytarabine (therapeutic use)
  • Decitabine (therapeutic use)
  • Disease-Free Survival
  • Female
  • Granulocyte Colony-Stimulating Factor (therapeutic use)
  • Humans
  • Leukemia, Myeloid, Acute (drug therapy, mortality)
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate
  • Treatment Outcome

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