Clinical Research Papers:
Decitabine-based chemotherapy followed by haploidentical lymphocyte infusion improves the effectiveness in elderly patients with acute myeloid leukemia
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Yu Jing1,*, Xiangshu Jin1,*, Lixin Wang1,2,*, Liping Dou1, Quanshun Wang1, Yushi Yao1, Shimei Lian3, Jihao Zhou1, Haiyan Zhu1, Zilong Yao1, Lijun Gao1, Lili Wang1, Yonghui Li1, Xuefeng Bai4, Meiyun Fang5 and Li Yu1
1 Department of Hematology, Chinese PLA General Hospital, Beijing, China
2 Department of Hematology, Navy General Hospital of PLA, Beijing, China
3 Department of Hematology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian, China
4 Department of Pathology and Comprehensive Cancer Center, The Ohio State University Medical Center, Columbus, OH, USA
5 Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
* These authors have contributed equally to this work
Li Yu, email:
Meiyun Fang, email:
Keywords: decitabine, haploidentical lymphocyte infusion, Induction therapy, acute myeloid leukemia
Received: November 01, 2015 Accepted: July 16, 2016 Published: August 10, 2016
In this study, we first initiated a multicenter, single-arm, phase-II clinical trial using decitabine (DAC) (20mg/m2 for five days) based chemotherapy, followed by haploidentical lymphocyte infusion (HLI) that was applied as induction therapy for elderly patients with AML. Furthermore, the role of HLI infusion was explored in a mouse model. The clinical trial included 29 elderly patients (median age: 64, range 57-77) with AML. Sixteen cases achieved complete remission (CR) and 9 cases achieved partial remission (PR) after the first treatment cycle. Of the patients with PR, 5 subjects achieved remission after the second induction, which brings the overall CR rate to 72.4%. The 2-year overall survival (OS) and disease-free survival (DFS) was 59.6% and 36.9% respectively. The treatment regimen was well tolerated with only one patient died of severe pneumonia one month after the first treatment. In the mouse experiment, we found that DAC/HLI significantly enhanced the survival of leukemic mice. These results suggested that DAC-based chemotherapy combined with HLI is an alternative first line induction therapy for elderly patients with AML. This trial is registered at ClinicalTrials.gov (NCT01690507).
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