Oncotarget

Clinical Research Papers:

HAG regimen improves survival in adult patients with hypocellular acute myeloid leukemia

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Oncotarget. 2016; 7:3623-3634. https://doi.org/10.18632/oncotarget.6211

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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

Correspondence to:

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

Abstract

Background:

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.

Results:

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).

Conclusions:

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.