[Curative effect of low dose cytarabine and aclarubin in combination with granulocyte colony-stimulating factor priming (CAG regimen) on patients with the intermediate and high-risk myelodysplastic syndrome].
OBJECTIVE
To evaluate the curative effect and adverse effect of low dose cytarabine and aclarubin in combination with granulocyte colony-stimulating factor priming (CAG regimen) on patients with the intermediate and high-risk myelodysplastic syndrome.


METHODS
A: total of 46 patients with intermediate and high-risk myelodysplastic syndrome was retrospectively analyzed. Twenty-eight patients received CAG regimen and 18 received conventional chemotherapy. CAG regimen: aclarubicin 10 mg/(m2.d)intravenously daily, Day 1~8; cytarabine 10 mg/ m2 subcutaneously once every 12 hours, Day 1~14; and subcutaneously use of granulocyte colony-stimulating factor 200 mug/(m2.d) until 12 hours before the last use of cytarabine. The initial outcome was evaluated after the first course of treatment. The responders received the second course. The ultimate therapeutic effect was evaluated after the 2 courses.


RESULTS
The overall response rate in the CAG regimen group was 78.6% (22/28). Thirteen patients (46.4%) responded, 5 (17.9%) showed partial response, and 4 (14.3%) hematologic improvement. The overall response rate in the conventional chemotherapy group was 50%(9/18). Six patients (33.3%) achieved complete response, 2 (11.1%) partial response, and 1(5.6%) hematologic improvement. The overall response rate of the CAG group was significantly higher than that in the control group (P<0.05). The adverse effects of CAG regimen were bearable.


CONCLUSIONS
With acceptable adverse effect, CAG regimen is effective for the intermediate and high-risk myelodysplastic syndrome. Long-time outcome needs further observation.
Zhu
Yan
Y
Department of Hematology, Xiangya Hospital, Central South University, Changsha 410008, China. zhuyanlg@hotmail.com
He
Yanjuan
Y
Chen
Shuping
S
D015250:Aclarubicin / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin