Low dose of homoharringtonine and cytarabine combined with granulocyte colony-stimulating factor priming on the outcome of relapsed or refractory acute myeloid leukemia

J Cancer Res Clin Oncol. 2011 Jun;137(6):997-1003. doi: 10.1007/s00432-010-0947-z. Epub 2010 Dec 9.

Abstract

Background: To explore the effect of low dose of homoharringtonine (HHT) and cytarabine (Ara-c) combined with granulocyte colony-stimulating factor (G-CSF) priming (HAG regimen) on relapsed or refractory acute myeloid leukemia (AML).

Methods: Sixty-seven patients with relapsed or refractory acute myeloid leukemia (AML) were enrolled. All the patients were treated with HAG regimen (HHT 1.5 mg/m(2)/day, 1-14d; Ara-C 7.5 mg/m(2)/12 h, 1-14d; G-CSF 150 μg/m(2)/day, according to the counting of the peripheral white blood cells). Blood cell counting, liver, kidney function, ECG and myocardial enzymes were monitored regularly.

Results: Thirty-five of 67 (52.2%) patients achieved complete remission (CR) and 8/67 (11.9%) partial remission (PR). The overall response rate was 64.1%. Myelosuppression was the most frequently observed adverse effect. Sixty of 67 (89.5%) patients suffered from grade 1-4 adverse effects of hematologic toxicity (according to World Health Organization criteria) and non-hematologic toxicity was mild.

Conclusion: In conclusion, HAG regimen was effective and tolerated well in refractory or relapsed AML. As a promising regimen for relapse or refractory AML, further observations should be made.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cytarabine / administration & dosage*
  • Cytarabine / adverse effects
  • Cytarabine / therapeutic use
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Harringtonines / administration & dosage*
  • Harringtonines / adverse effects
  • Harringtonines / therapeutic use
  • Homoharringtonine
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / mortality
  • Male
  • Middle Aged
  • Receptors, CXCR4 / analysis
  • Recurrence

Substances

  • Harringtonines
  • Receptors, CXCR4
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • Homoharringtonine