PurposeThis prospective phase II, open label, study was designed to assess the efficacy and safety of D-CAG induction treatment for elderly patients with newly diagnosed AML.Experimental DesignAll patients in this study were treated with decitabine of 15 mg/m2 for 5 days and G-CSF for priming, in combination with cytarabine of 10-mg/m2 q12h for 7 days and aclarubicin of 10 mg/day for 4 days (D-CAG).ResultsAmong 85 evaluable patients, overall response rate (ORR) and complete remission (CR) were 82.4% and 64.7%, respectively, after 1 cycle of therapy. The ORR in patients aged <70 years was 83.0% and 81.6% in patients aged ≥70 years. There was a significantly longer median overall survival (OS) in patients with response (16 months) than in those without response (7 months, p< 0.0001). The OS for patients aged ≥70 years and 60-69 years was 10 months and 12 months, respectively (p=0.4994). The two-year OS probability was 19.2% and the twenty-month survival rate was 33.8%. Induction mortality of D-CAG treated elderly patients with AML is 4.4%.ConclusionD-CAG regimen was well tolerated and showed a promising clinic efficacy in elderly patients with AML (≥70 years).
The utility of graft-versus-host disease (GVHD) prophylaxis with cyclosporine (CSA), methotrexate (MTX), and antihuman thymocyte globulin (ATG) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) exists in the literature; however, up to now, it has not yet been fully described. This study was to observe the influence of adding ATG on GVHD prophylaxis and the quality of life (QoL) of 96 hemopathic patients after allo-HSCT. We retrospectively analyzed the outcomes of 96 consecutive patients undergoing allo-HSCT, including 54 patients who received ATG regimen without in vitro T cell depletion (TCD) (ATG group) and 42 patients who received neither ATG regimen nor TCD (control group). All patients were followed up, and the factors, including age, sex, HLA and ABO compatibility, related and unrelated donors, and disease status, were undertaken to analysis. All patients in the study achieved trilineage engraftment with full-donor chimerism. The cumulative incidence of acute GVHD (aGVHD) was lower in the ATG group than that in the control group (29.6% versus 57.1%, P = .006), and the cumulative incidence of chronic GVHD (cGVHD) was 35.2% for patients with ATG and 66.7% for patients without ATG (P < .01). Notably, the proportion of patients with Karnofsky scores of >90 was 70.4% in the patients with ATG, and 28.6% in the patients without ATG (P < .001). Furthermore, the cumulative incidence of patients with opportunistic infection was significantly different in both groups posttransplantation, with 44.4% and 19.1% in recipient patients with or without ATG respectively (P < .05). Additional usage of ATG not only decreases the occurrence of aGVHD and cGVHD, but also improves QoL of patients after allo-HSCT without affecting stem cell engraftment or overall survival.
The Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway is active in both normal hematopoiesis and hematological malignancies. Moreover, Janus kinase-2 (JAK2) is the key hematopoietic kinase, and mutations together with single nucleotide polymorphisms (SNPs) of JAK2 have been thoroughly evaluated. In this study, we aimed to investigate whether the synonymous genetic polymorphism A830G in the JAK2 gene is associated with the treatment outcomes of Ara-C-based chemotherapy regimens in patients with acute myeloid leukemia (AML). A total of 152 patients with AML in a Chinese population were enrolled in our study. Peripheral blood samples drawn at the time of diagnosis were analyzed for the presence of JAK2 A830G by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF-MS). The results showed that frequencies of the AA genotype were higher in the group 40-60 years old, higher white blood cell (WBC) patient group, homoharringtonine and Ara-C (HA) regimen group, and good therapy response group, and patients with the GG genotype were significantly associated with a higher rate of early death. We conclude that the AA and GG genotypes of JAK2 A830G might be important markers for therapy outcomes of patients with AML in a Chinese population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.