Clinical Response Of IA Compared With DA Regimens In The Treatment Of Newly Diagnosed Acute Myeloid Leukemia

ObjectiveCompare the effectiveness and adverse reactions of two chemotherapy regimens [idarubicin+cytarabine (IA) and daunorubicin+cytarabine (DA)] in patients with acute myeloid leukemia (AML) in order to find the better chemotherapy regimens.MethodFrom Jan2009to Nov2011, there were64newly diagnosed AML patients (except APL patients) randomized into IA or DA group in Shandong Provical hospital, all cases were diagnosed based on morphological and staining characteristics of bone marrow cells stained with Wright-Giemsa, and category diagnosed according to FAB classification criteria, all of the specimens of bone marrow cells had immune phenotype and some had karyotype examination. Since the patients were in the hospital, they should check the blood routine and body temperature daily, liver function, ECG before and after the chemotherapy, myocardial enzyme spectrum when necessary. The bone marrow examination was checked after hematopoiesis function was recovered after one therapy. All the indicators are tested by fully automatic blood cells and biochemical analyzer. During chemotherapy the patients were given liver protector, anti-vomiting drugs. When neutrophils less than0.5x109/L, Hb content less than60g/L, platelet below10x109/L, patients were given granulocyte stimulating factor, red blood cell transfusion or platelets, the infected were given sensitive antibiotic treatment.In the retrospect analysis, the sex, age, category, clinical manifestation and the laboratory result were analyzed, the follow-up visits were done in order to observe and evaluate complete remission rate (CR), total remission rate (TRR), and adverse reactions in the treatment. The data were analyzed by SPSS17.0, P<0.05was considered statistical significant.ResultsThe two groups were considered having no statistical significant in sex, age, category and blood routine before the treatment. In64patients,20cases in IA group and44in DA group, CR was79.2%and TRR(CR+PR) was91.7%in IA group and47.5%,60.0%in DA group,correspondingly (P<0.05). The survival time of DA group is a little longer than the IA group, which is16.3months to16.0months. During chemotherapy blood routine was monitored daily, lacking of neutrophils of IA group in average was11.0days, DA group was6.0days. Platelet of IA group less than20x10/L was7.6days, DA group was5.0days.Bone marrow inhibition of IA group was stronger than DA group,100%of patients were infected in IA group, DA group was82.5%, which was statistically significant (P<0.05).There were no differences in adverse reactions. The infection rate is higher in the IA group. In both groups there are nausea, vomiting, heart electrocardiogram abnormalities and other adverse reactions, after conventional treatment the chemotherapy still can continue. There were no differences in adverse reaction between the two groups.ConclusionsFor the newly diagnosed acute myeloid leukemia patients, the IA regimen is better than DA regimen in CR, but the infection rate is also higher, the support treatment is very important, and the survival time was effected by various factors. There were no differences in adverse reaction between the two groups.