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Homoharringtonine in combination with cytarabine and aclarubicin in the treatment of refractory/relapsed acute myeloid leukemia: a single-center experience

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Abstract

To assess the efficacy and toxicity of HAA regimen (Homoharringtonine 4 mg/m2/day, days 1–3; cytarabine 150 mg/m2/day, days 1–7; aclarubicin 12 mg/m2/day, days 1–7) as a salvage therapy in the treatment of refractory and/or relapsed acute myeloid leukemia (AML), 46 patients with refractory and/or relapsed AML, median age 37 (16–65) years, participated in this clinical study. The median follow-up was 41 (10–86) months. Eighty percent of patients achieved complete remission (CR), and the first single course of re-induction HAA regimen resulted in CR rate of 76.1 %. The study protocol allowed two courses of induction. The CR rates of patients with favorable, intermediate and unfavorable cytogenetics were 90 %, 88.9 %, and 37.5 %, respectively. For all patients, the estimated 3-year overall survival (OS) rate was 42 %, and the estimated relapse free survival (RFS) at 3 years for the 36 CR cases was 49 %. The toxicities associated with HAA regimen were acceptable. HAA is a good choice in cases with refractory/relapsing AML for salvage chemotherapy, preferably with a high-efficacy and low-toxicity profile.

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Acknowledgments

This work was supported by National Natural Science Foundation of China (Grant #30900641), Science Research Fundation of Health Department of Zhejiang Province (Grant #2008B063 and Grant #2009B046) and Research Fund for the Doctoral Program of Higher Education of China (Grant #20090101120112).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Hematology, the First Affiliated Hospital, Zhejiang University College of Medicine, No. 79 Qingchun Road, 310003, Hangzhou, Zhejiang, People’s Republic of China

    Wenjuan Yu, Liping Mao, Jiejing Qian, Wenbin Qian, Haitao Meng, Wenyuan Mai, Hongyan Tong, Yin Tong & Jie Jin

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  1. Wenjuan Yu
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  2. Liping Mao
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  3. Jiejing Qian
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  8. Yin Tong
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Correspondence to Jie Jin.

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Yu, W., Mao, L., Qian, J. et al. Homoharringtonine in combination with cytarabine and aclarubicin in the treatment of refractory/relapsed acute myeloid leukemia: a single-center experience. Ann Hematol 92, 1091–1100 (2013). https://doi.org/10.1007/s00277-013-1758-5

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