title: Efficacy of low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) compared to Hyper-CVAD regimen as salvage chemotherapy in relapsed/refractory Philadelphia chromosome-negative acute lymphoblastic leukemia.
abstract: We treated 90 relapsed/refractory Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph(-)-ALL) patients with CAG regimen [cytarabine (10mg/m(2)/12h, days 1-14), aclarubicin (5-7 mg/m(2)/day, days 1-8), granulocyte colony-stimulating factor (200 μg/m(2)/day, days 1-14)], 82 relapsed/refractory Ph(-)-ALL patients were treated with increasing aclarubicin dose CAG (5-7 mg/m(2)/day, days 1-14, HD-CAG). 96 relapsed/refractory Ph(-)-ALL patients treated with Hyper-CVAD regimen (control group). After one therapy course, among all groups, there were no statistically significant differences with complete remission (CR) and overall response [OR, CR+partial remission (PR)] rates (P>0.05). In CAG group, CR and OR rates for T-ALL exceeded those for B-ALL (P=0.001, 0.007), while in HD-CAG and control groups, those were not statistically significantly different (P>0.05). CR and OR rates of CAG group for B-ALL were lower than control group (P=0.004, 0.012). Among all groups, there were no statistically significant differences with CR and OR rates for T-ALL (P>0.05). CAG had lesser adverse event than Hyper-CVAD. The overall survival at 3 years for all groups were similar. Efficacy of CAG regimen was similar in comparison to Hyper-CVAD for relapsed/refractory Ph(-)-T-ALL. HD-CAG could not improve efficacy than CAG regimen.
authors: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China; Department of Hematology, Huai'an Hospital Affiliated to Xuzhou Medical College, Huai'an Second People's Hospital, Huai'an, Jiangsu Province 223002, PR China.
authors: Limin
authors: L
authors: Liu
authors: Department of Hematology, Xian Yang Central Hospital, Xianyang, Shanxi Province 712000, PR China.
authors: Wenjing
authors: W
authors: Jiao
authors: Department of Hematology, Huai'an Hospital Affiliated to Xuzhou Medical College, Huai'an Second People's Hospital, Huai'an, Jiangsu Province 223002, PR China.
authors: Yanming
authors: Y
authors: Zhang
authors: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China.
authors: Qi
authors: Q
authors: Qu
authors: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China.
authors: Xiaoli
authors: X
authors: Li
authors: The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key laboratory of Thrombosis and Hemostasis of Ministry of Health, Collaborative Innovation Center of Hematology, Suzhou, Jiangsu Province 215006, PR China. Electronic address: wudepei@medmail.com.cn.
authors: Depei
authors: D
authors: Wu
mesh_terms: D015250:Aclarubicin / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D014750:Vincristine; D015250:Aclarubicin; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide
keywords: Acute lymphocytic leukemia; CAG regimen; Refractory; Relapse; Salvage therapy