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Increasing the dose of aclarubicin in low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) can safely and effectively treat relapsed or refractory acute myeloid leukemia

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Abstract

It is difficult for relapsed and refractory acute myeloid leukemia (AML) patients to achieve complete remission (CR). The CAG regimen [low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (G-CSF)] has been used to treat relapsed and refractory AML patients, and showed good therapeutic efficacy. It is unknown, however, whether increasing the dose of aclarubicin in CAG regimen could treat relapsed or refractory AML safely and effectively. We evaluate the efficacy and tolerability of increasing the dose of aclarubicin in CAG regimen, in 37 relapsed or refractory AML patients. All patients were treated with CAG regimen including low-dose cytarabine (10 mg/m2 every 12 h, days 1–14), aclarubicin (5–7 mg/m2 every day, days 1–14), and G-CSF (200 μg/m2 every day, days 1–14) priming. After a single course of therapy, the overall response [CR + partial remission (PR)] rate of all patients was 78.4 % (29/37), in which the CR rate was 62.2 % (23/37). There was no early death. The median overall survival was 6 months (range 2–36 months). Myelosuppression was ubiquitous, but tolerated. No severe non-hematologic toxicity was observed. Thus, increasing the dose of aclarubicin in CAG regimen can be used safely and effectively in the treatment of relapsed or refractory AML.

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Acknowledgments

This work was supported by the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), Jiangsu Province’s Key Medical Center (ZX201102), National Clinical Key Specialty Development Project and National Public Health Grand Research Foundation (No.201202017).

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Authors and Affiliations

  1. The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, 188 Shizi Street, Suzhou, 215006, Jiangsu, People’s Republic of China

    Limin Liu, Zhengming Jin & Depei Wu

  2. Department of Hematology, The Second People’s Hospital of Huai’an, 62 Huaihai South Street, Huai’an, 223002, People’s Republic of China

    Limin Liu, Yanming Zhang, Xingxia Zhang, Guangsheng Zhao, Yejun Si, Guoqiang Lin, Aidi Ma, Yingxin Sun & Li Wang

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  1. Limin Liu
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  2. Yanming Zhang
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  3. Zhengming Jin
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  4. Xingxia Zhang
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  5. Guangsheng Zhao
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  9. Yingxin Sun
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  10. Li Wang
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  11. Depei Wu
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Corresponding author

Correspondence to Depei Wu.

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L. Liu and Y. Zhang contributed equally to this work.

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Liu, L., Zhang, Y., Jin, Z. et al. Increasing the dose of aclarubicin in low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor (CAG regimen) can safely and effectively treat relapsed or refractory acute myeloid leukemia. Int J Hematol 99, 603–608 (2014). https://doi.org/10.1007/s12185-014-1528-8

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  • DOI: https://doi.org/10.1007/s12185-014-1528-8

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