Clinical Research Papers:
HAG regimen improves survival in adult patients with hypocellular acute myeloid leukemia
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Xiaoxia Hu1,*, Weijun Fu2,*, Libing Wang1, Lei Gao1, Shuqin Lü1, Hao Xi2, Huiying Qiu1, Li Chen1, Jie Chen1, Xiong Ni1, Xiaoqian Xu1, Weiping Zhang1, Jianmin Yang1, Jianmin Wang1 and Xianmin Song1
1 Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China
2 Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai, China
* These authors have contributed equally to this paper
Xianmin Song, email:
Jianmin Wang, email:
Keywords: hypocellular, acute myeloid leukemia, induction regimen, prognosis
Received: June 02, 2015 Accepted: October 08, 2015 Published: October 21, 2015
Hypocellular acute myeloid leukemia (Hypo-AML) is a rare disease entity. Studies investigating the biological characteristics of hypo-AML have been largely lacking. We examined the clinical and biological characteristics, as well as treatment outcomes of hypo-AML in our institutes over a seven years period.
Design and Methods:
We retrospectively analyzed data on 631 adult AML patients diagnosed according to the French-American-British (FAB) classification and WHO classification of tumors of haematopoietic and lymphoid tissue, including 43 patients with hypo-AML. Biological variables, treatment outcomes and follow-up data on hypo-AML patients were analyzed.
Out of 631 AML patients, 47 (7.4%) were diagnosed as hypo-AML, out of which 43 patients were evaluable. Compared with non-hypocellular AML, hypo-AML patients tended to be older (P = 0.05), more likely to present with leukocytopenia (P < 0.01) and anterior hematological diseases (P = 0.02). The overall complete remission (CR) rate, disease free survival (DFS), and overall survival (OS) in hypo-AML patients were comparable to those in non-hypo AML patients. Twenty-seven (62.8%) patients with hypocellular AML were treated with the standard regimen of anthracyclines and cytarabine (XA) (associated CR rate: 51.9%; median OS: 7 months; median DFS: 6.5 months). Sixteen (37.2%) patients were treated with a priming regimen containing homoharringtonine, cytarabine and G-CSF (HAG) (associated CR rate: 81.25%; median OS: 16 months; median DFS: 16 months).
The overall prognosis of hypo-AML was not inferior to that of non-hypo AML. HAG regimen might increase response rates and improve survival in hypo-AML patients.
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