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Erschienen in:
01.10.2011 | Original Paper
Efficacy and safety of CHG regimen (low-dose cytarabine, homoharringtonine with G-CSF priming) as induction chemotherapy for elderly patients with high-risk MDS or AML transformed from MDS
Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 10/2011
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Background
To evaluate the efficacy and toxicity of CHG regimen (low-dose cytarabine, homoharringtonine with G-CSF priming) as an induction chemotherapy for elderly patients with high-risk MDS or acute myeloid leukemia transformed from MDS (MDS–AML).
Methods
Thirty-three untreated patients (21 high-risk MDS and 12 MDS–AML) were enrolled in this study. Each patient was administered with the CHG regimen comprised of low-dose cytarabine (25 mg/day, days 1–14) and homoharringtonine (1 mg/day, days 1–14) by intravenous continuous infusion in combination with G-CSF (300 μg/day) by subcutaneous injection from day 0 until neutrophil count recovery to 2.0 × 109/L.
Results
The overall response rate (OR) was 66.7% after one course of the CHG regimen with 19 patients reaching CR (57.6%) and 3 patients reaching partial remission (PR) (9.1%). The median overall survival (OS) was 15.0 months. Patients with normal serum lactate dehydrogenase (LDH) appeared longer median OS when compared to patients with high LDH level (18 months vs. 5 months, P = 0.011). Grade 3/4 thrombocytopenia occurred in 28% of patients, neutropenia in 34%. No treatment-related deaths occurred during the induction therapy.
Conclusions
These data suggest that the CHG priming regimen is effective and safe as a novel induction therapy for elderly patients with high-risk MDS and MDS–AML. The results need to be conformed in further study involving a larger cohort of patients.