title: Homoharringtonine in combination with cytarabine and aclarubicin in the treatment of refractory/relapsed acute myeloid leukemia: a single-center experience.
abstract: To assess the efficacy and toxicity of HAA regimen (Homoharringtonine 4 mg/m(2)/day, days 1-3; cytarabine 150 mg/m(2)/day, days 1-7; aclarubicin 12 mg/m(2)/day, days 1-7) as a salvage therapy in the treatment of refractory and/or relapsed acute myeloid leukemia (AML), 46 patients with refractory and/or relapsed AML, median age 37 (16-65) years, participated in this clinical study. The median follow-up was 41 (10-86) months. Eighty percent of patients achieved complete remission (CR), and the first single course of re-induction HAA regimen resulted in CR rate of 76.1 %. The study protocol allowed two courses of induction. The CR rates of patients with favorable, intermediate and unfavorable cytogenetics were 90 %, 88.9 %, and 37.5 %, respectively. For all patients, the estimated 3-year overall survival (OS) rate was 42 %, and the estimated relapse free survival (RFS) at 3 years for the 36 CR cases was 49 %. The toxicities associated with HAA regimen were acceptable. HAA is a good choice in cases with refractory/relapsing AML for salvage chemotherapy, preferably with a high-efficacy and low-toxicity profile.
authors.affiliation: Department of Hematology, the First Affiliated Hospital, Zhejiang University College of Medicine, No. 79 Qingchun Road, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Yu
authors.forename: Liping
authors.initials: L
authors.lastname: Mao
authors.forename: Jiejing
authors.initials: J
authors.lastname: Qian
authors.forename: Wenbin
authors.initials: W
authors.lastname: Qian
authors.forename: Haitao
authors.initials: H
authors.lastname: Meng
authors.forename: Wenyuan
authors.initials: W
authors.lastname: Mai
authors.forename: Hongyan
authors.initials: H
authors.lastname: Tong
authors.forename: Yin
authors.initials: Y
authors.lastname: Tong
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D006248:Harringtonines / Q000008:administration & dosage / Q000009:adverse effects; D006331:Heart Diseases / Q000139:chemically induced; D000077863:Homoharringtonine; D006801:Humans; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000139:chemically induced; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000601:surgery; D015479:Leukemia, Myelomonocytic, Acute / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D055815:Young Adult
chemical_list: D006248:Harringtonines; D003561:Cytarabine; D000077863:Homoharringtonine; D015250:Aclarubicin