CURATIVE EFFECT AND SAFETY OF 2-CDA, ARA-C AND G-CSF COMBINED TREATMENT FOR RELAPSED REFRACTORY ACUTE MYELOID LEUKEMIA

Xiaoxiang Zhang¹, Ying Chen^{1, *}, Lihong Shou², Jianghua Yang³ 

¹Department of Laboratory, HuZhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou 313000, PR China - ²Department of Hematology, HuZhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou 313000, PR China - 

³Department of Radiology, HuZhou Central Hospital, Affiliated Central Hospital HuZhou University, Huzhou 313000, PR China

Objective: To investigate the curative effect and safety of purine analogues-Cladribine (2-CdA), cytosine arabinoside (Ara-C) and granulocyte colony-stimulating factor (G-CSF) combined treatment of relapsed refractory acute myeloid leukemia (AML). 

Methods: Eighty-four patients with relapsed refractory acute myeloid leukemia treated in the Department of Hematology of our hospital from July 2017 to July 2018 were selected for this study, and randomly divided into the control group (n=42) and the study group (n=42). The control group was treated with FLAG (Fludarabine + Ara-C + G-CSF) protocol and the study group was treated with CLAG (2-CdA + Ara-C + G-CSF) protocol to analyze and compare the curative effect and safety of the two groups of patients with relapsed refractory acute myeloid leukemia.

Results: After two courses of treatment, in the study group, complete remission (CR) was 38.10%, partial remission (PR) was 54.76% and no remission (NR) was 7.14%; and in the control group, CR was 19.05%, PR was 47.62% and NR was 33.33%. The overall response (OR; CR + PR) of the study group was 92.86%, which was significantly higher than that of the control group (66.67%), and the difference was statistically significant (P<0.01). During the course of treatment, the incidence of adverse reactions such as infection, neutropenia, drug-induced liver injury, thrombocytopenia, nausea and vomiting, and mucocutaneous hemorrhage in the study group was significantly lower than that in the control group, with statistically significant differences (P<0.01). After one year of follow-up, it was found that the total survival time and recurrence-free survival time in the study group were remarkably higher than those in the control group, the mortality rate was lower than that in the control group, and the survival rate was higher than that in the control group, and the difference was statistically significant (P<0.05).

Conclusion: The treatment of relapsed refractory AML with 2-CdA, Ara-C and G-CSF regimen has better curative effect, higher safety and better prognosis, and can therefore be widely used in clinical practice.