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


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.


RESULTS
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).


CONCLUSIONS
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.
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xiaoxia
X
Hu
Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Weijun
W
Fu
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Libing
L
Wang
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Lei
L
Gao
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Shuqin
S
Lü
Department of Hematology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Hao
H
Xi
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Huiying
H
Qiu
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Li
L
Chen
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Jie
J
Chen
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xiong
X
Ni
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xiaoqian
X
Xu
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Weiping
W
Zhang
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Jianmin
J
Yang
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Jianmin
J
Wang
Department of Hematology, Institute of Hematology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xianmin
X
Song
D000293:Adolescent; D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
D018943:Anthracyclines; D003561:Cytarabine
acute myeloid leukemia; hypocellular; induction regimen; prognosis