Low dose of homoharringtonine and cytarabine-based priming induction regimens for patients with de novo acute myeloid leukemia and high-risk myelodysplastic syndrome aged over 70 years

ABSTRACT

Objectives

Our objective is to retrospectively analyze the response to low dose of homoharringtonine (HHT) and cytarabine-based priming induction regimens in patients above 70 years with de novo acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS).

Patients and methods

We retrospectively analyzed these very elderly newly diagnosed patients with AML and high-risk MDS, who received low dose of HHT and cytarabine-based priming induction regimens between March 2006 and September 2019.

Results

Of the 24 patients, 11 patients (47.8%) achieved complete remission (CR) and 3 (13%) partial remission, and the overall response rate was 60.9%. The estimated median overall survival (OS) time was 12 months and the 1-year OS rate was 47.8%. Patients without CR and Charlson’s Comorbidity Index > 2 may be the two independent prognostic factors. The median OS was significantly higher for patients with CR after induction chemotherapy than those without CR (22.93 vs. 8.5 months, p < .01).

Conclusion

Our study provides a hint of the efficacy of low dose of HHT and cytarabine-based priming induction regimens for patients aged over 70 years with de novo AML and high-risk MDS should be further studied.

KEYWORDS:

• Acute myeloid leukemia
• 70 years old
• HHT
• Charlson’s comorbidity index
• overall survival

Acknowledgments

The authors would like to thank Prof. Wenjing Gao (School of Public Health, Peking University, China) and Guifen Liu (School of Public Health, Shanxi Medical University, China) for the help in the statistical analysis of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported, in part, by grants from the Beijing Xisike Clinical Oncology Research Foundation [Y-Roche2019/2-0034] and Beijing Huaxin Hospital Linghang Foundation [Grant Number 2020-LH-01].