Efficacy And Safety Of AZA Combined With HA In The Treatment Of Acute Myeloid Leukemia Patients With 3+7 Conventional Regimen Intolerance

Objective: To evaluate the efficacy and safety of azacitidine(AZA)combined with homoharringtonine(HHT)and low-dose cytarabine(LDAC)in the treatment of acute myeloid leukemia(AML).Methods: The clinical characteristics,efficacy,prognosis and adverse events of 33 AML patients(15 newly diagnosed and 18relapsed/refractory)admitted to our center were retrospectively analyzed.Results: Among 33 AML patients treated with this regimen,the median age was 55 years,9 patients were at intermediate-risk cytogenetic risk,and 18 patients were at high-risk cytogenetic risk.Among the 33 patients,3 patients were lost to follow-up and 1 patient had incomplete data.Among the remaining 29 patients who received AZA+HHT+LDAC treatment,the overall response rate(ORR)was 79.3%;the median progression-free survival(PFS)was 7.0 months.In subgroup analyses including age,sex,ECOG score,disease classification,bone marrow blasts,peripheral white blood cells,risk stratification,and epigenetic abnormalities,only the ECOG score was associated with response rate and PFS has something to do with it.The remaining 29 patients received a total of 69 cycles of AZA + HHT + LDAC(excluding treatment cycles in patients lost to follow-up).The 69 cycles were retrospectively graded according to common toxicity criteria for adverse events(CTC AE version 5.0).Hematologic adverse events following AZA+HHT+LDAC treatment included leukopenia,anemia,thrombocytopenia,agranulocytosis,febrile neutropenia,and hemorrhage(Table 3).The most common hematologic adverse events of grade 3 or higher were thrombocytopenia(54/69,78.3%);agranulocytosis(48/69,69.6%).Common non-hematologic adverse events following AZA+HHT+LDAC treatment included nausea(27.5%),infection(24.6%),and hypokalemia(26.1%).Conclusion: AZA combined with HHT and LDAC has a good curative effect in the treatment of acute myeloid leukemia,and the adverse reactions are controllable.6 figures,13 tables,and 46 references.