The Efficacy And Safety Of The HAA Regimen In The Treatment Of Refractory/Relapsed Acute Myeloid Leukemia

Objective To evaluate the efficacy and safety of the HAA regimen (homoharringtonine,cytarabine and aclarubicin) as salvage chemotherapy in the treatment of refractory/relapsed acute myeloid leukemia. Methods We retrospectively analyzed64patients with refractory/relapsed acute myeloid leukemia who received the HAA regimen as salvage chemotherapy. The complete remission(CR) was analyzed. Kaplan-Meier method was used to estimate overall survival(OS) and relapse free survival(RFS), and the differences were compared by Log-rank test. Results The overall CR rate was70.1%and65.7%of the patients attained CR after the first induction cycle. The early death rate was0%. The median follow-up time was61(range:6-120) months. The estimated3-year OS rate was46.8%and the estimated3-year RFS rate was42.8%. The CR rates of patients with favorable, intermediate and unfavorable cytogenetics were76.4%and33.3%, respectively. The3-year OS of favorable and intermediate group were53.7%and10%. The median survival time of unfavorable group was only8months. The side effects associated with the HAA regimen were tolerable, in which the most common toxicities were myelosuppression and infection. Conclusion HAA regimen is associated with a higher rate of CR and longer-term survival and its toxicity can be tolerated. The regimen is suitable for refractory/relapsed AML patients with favorable or intermediate risk.