| Background: Acute myeloid leukemia(AML)is a bone marrow hematopoietic stem / progenitor cells which is origin of malignant disease,that is a group of highly heterogeneous disease.Most cases were acute onset,severe illness,prognosis is poor,if not treated timely,the median survival phase is only three months.Currently,the canonical remission-induction regimen for AML is the “3 + 7” regimen based on anthracyclines and cytarabine,also includes component blood transfusion,timely and effective antibiotic use strong support treatment greatly improved the prognosis of AML.Studies from home and abroad have shown that 65%-85% of AML patients can achieve complete remission.As a novel anthracycline agent,idarubicin has become the commonly used induction agent for AML,just like daunorubicin.However,there is no definite theory about the difference of curative effect between the two drugs at home and abroad.On the other hand,due to the economic tolerance of Chinese people,the domestic idarubicin(Ainuoning)has been widely used in clinical practices in recent years,while there is no clear conclusion on its therapeutic efficacy,side effects and the difference between it and the imported idarubicin(Zavedos).Objective: To observe and analyze the therapeutic efficacy and side effects of idarubicin(IDA)(domestic and imported)and daunorubicin(DNR)in combination with cytarabine as the chemotherapeutic regimens,respectively in the treatment of non-M3 subtype acute myeloid leukemia in treatment-naive adults.Methods: The clinical data of 282 treatment-naive AML patients admitted to the Department of Hematology,Second Hospital of Hebei Medical University from July 1,2012 to November 30,2015 were retrospectively analyzed.221 patients were used the IA regimen(idarubicin(8-10)mg/m2/d,d1-3;cytarabine(100-200)mg/m2/d,d1-7),123 used Zavedos and 98 given Ainuoning.Besides,61 patients were used the DA regimen(daunorubicin(45-60)mg/m2/d,d1-3;cytarabine(100-200)mg/m2/d,d1-7).The clinical efficacy and the incidence of adverse reactions of patients were analyzed and compared after the treatment in the three groups.Results:1The CR rates of the three regimens for non-M3 subtype AML in treatment-naive adults were(from high to low): 85.4% in the Zavedos group,75.5% in the Ainuoning group and 57.4% in the daunorubicin group,and the three groups were statistically different in CR rates(P <0.001),while there were no significant differences in adverse reactions between the three groups.2Compared with daunorubicin,idarubicin showed good efficacy,and its efficacy was proportional to its dose.Compared with Zavedos,the remission rate of Ainuoning was slightly lower.3The three strategy had significant efficacy,and the main chemotherapy-related adverse events in the three groups were myelosuppression,infection,nausea and vomiting,etc.The adverse reactions were in a controlled range,and thus they could all be used as first-line anti-leukemia agents.Conclusion: All the three strategy can exhibit significant efficacy when used in combination with cytarabine as the induction therapies for AML in treatment-naive adults.The CR rate of idarubicin is higher than that of daunorubicin.Within the dosage range,the efficacy is proportional to the dose,and side reactions are controllable.The domestic idarubicin can achieve a similar therapeutic efficacy with the imported counterpart,and it can be used as a first-line anti-leukemia clinical agent. |
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