title: Effectiveness of homoharringtonine (omacetaxine mepesuccinate) for treatment of acute myeloid leukemia: a meta-analysis of Chinese studies.
abstract: The present meta-analysis provides an overview on the effectiveness of homoharringtonine (HHT) combination regimens to treat acute myeloid leukemia (AML). Because most of these studies were performed in China, Chinese published clinical studies were used for the analysis. A search for studies from 2006 to 2013 of regimens containing HHT for AML treatment was performed using published studies and Chinese databases in Mandarin. The complete response (CR) and overall response (OR) rates were analyzed, and the fixed effects model and random effects model (REM) were calculated. The heterogeneity of the studies was calculated using Q homogeneity statistics. The meta-analysis included 21 studies (n = 1310, n = 229 pediatric, and n = 216 elderly). HHT was given in combination with cytarabine, daunorubicin, idarubicin, aclacinomycin, mitoxantrone, or granulocyte colony-stimulating factor. Heterogeneity was seen in all analyzed pools, but it was most pronounced in retrospective studies. Overall, the REM showed a CR rate of 65.2%. However, in studies in which HHT-containing regimens were compared to regimens without HHT, the CR rates were 69.1% in randomized trials and 62.8% in retrospective studies. Additionally, in studies with exclusively elderly patients, the CR rate was considerably lower than it was for the studies with mixed age populations (47.5% vs. 65.2%). Higher overall CR rates for HHT-containing regimens in AML treatment in the Chinese studies suggest that HHT could be an active agent in the management of AML. Additional clinical trials are warranted to evaluate the efficacy of HHT in AML treatment.
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: hkantarjian@mdanderson.org.
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.affiliation: Teva Pharmaceuticals, Frazer, PA.
authors.forename: Gisoo
authors.initials: G
authors.lastname: Barnes
authors.affiliation: Teva Pharmaceuticals, Frazer, PA.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Pathak
authors.affiliation: University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
mesh_terms: D000367:Age Factors; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002681:China; D016208:Databases, Factual; D006248:Harringtonines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000077863:Homoharringtonine; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D006248:Harringtonines; D000077863:Homoharringtonine
keywords: China