Clinical Research Papers:

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

Xiaoxia Hu, Weijun Fu, Libing Wang, Lei Gao, Shuqin Lü, Hao Xi, Huiying Qiu, Li Chen, Jie Chen, Xiong Ni, Xiaoqian Xu, Weiping Zhang, Jianmin Yang, Jianmin Wang and Xianmin Song _

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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



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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