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Leukemia & Lymphoma Volume 57, 2016 - Issue 6
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Original Articles: Clinical

Epigenetic priming with decitabine followed by low-dose idarubicin/cytarabine has an increased anti-leukemic effect compared to traditional chemotherapy in high-risk myeloid neoplasms

Xing-Nong YeInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and ;Department of Hematology, The fourth Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China
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Xin-Ping ZhouInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
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Ju-Ying WeiInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
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Gai-Xiang XuInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Ying LiInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Li-Ping MaoInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Jian HuangInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;Department of Hematology, The fourth Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China
,
Yan-Ling RenInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Chen MeiInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Jing-Han WangInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Yin-Jun LouInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Li-Ya MaInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Wen-Juan YuInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
,
Li YeInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Li-Li XieInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Yin-Wan LuoInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Chao HuInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Lin-Mei NiuInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Min-Hua DouInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and
,
Jie JinInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China,
&
Hong-Yan TongInstitute of Hematology, Department of Hematology, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, ;MDS Center, The first Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China, and Correspondence[email protected]
 show all
Pages 1311-1318 | Received 05 Feb 2015, Accepted 03 Sep 2015, Published online: 13 Oct 2015
 
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Abstract

Decitabine (DAC) is commonly used for the treatment of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Previous studies have indicated DAC sequentially combined with idarubicin was an effective treatment for myeloid neoplasms. Therefore, a clinical study was conducted of the sequential combination of DAC followed by low-dose idarubicin/cytarabine in high-risk myeloid neoplasms. A total of 30 patients with a diagnosis of high-risk MDS, AML evolving from MDS or relapsed/refractory AML were enrolled in the study. DAC was administered 20 mg/m2 daily for 3 consecutive days. Idarubicin (3 mg/m2/day) was administered 24 h after the last administration of DAC for 5–7 consecutive days, combined with cytarabine (30 mg/m2/day) for 7–14 days. The overall complete remission rate was 66.67%. The results demonstrate that epigenetic priming with decitabine followed by low-dose idarubicin/ytarabine has an increased anti-leukemia effect compared to traditional chemotherapy in high-risk myeloid neoplasms.

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