Background: Prognosis of refractory and relapsed acute myeloid leukemia (r/r AML) is challenge and no standard of treatment exists. Cladribine based regimen in treatment of r/r AML proved to be effective,while the total rate of response is limited. Aims: To explore whether the addition of liposomal adriamycin can improve the response. Methods: We registered a clinical trial, which is CLAG plus liposomal adriamycin (CLAG+PLD) regimen for re-induction of r/r AML (ChiCTR1800017569), to observe the response, overall survival (OS) and disease free suivival (DFS) of the patients. In addition to that, CLAG alone as salvage therapy (no PLD group) for RR-AML in our medical center were chosen as historical comparison Results: To observe the response, overall survival (OS) and disease free suivival (DFS) of the patients. In addition to that, CLAG alone as salvage therapy (no PLD group) for RR-AML in our medical center were chosen as historical comparison.Of the 55 patients who were evaluable for remission after CLAG +PLD treatment(PLD group), 27（49.1%）achieved CR and negative of MRD, 12（21.8%）achieved CR and positive of MRD, 5（9.1%）achieved partial response, and 11（20%）no response. In Contrast, no PLD group has inferior response rate,with the corresponding data is 24（46.6%）, 6（10.9%）,10（18.2%）,and 13（23.6%）respectively (p= 0.008).As for the 2-year OS and DFS, the median OS and DFS for PLD group has not reached and 10 months for noPLD group (p= 0.023 and p= 0.045 respectively). The safety observation did not find increasing toxicity in PLD group.In subgroup analysis of PLD group, the response between FLT3-ITD mutated group and wild group showed significant difference (p=0.006). Moreover, hematopoietic stem cell transplantation (HSCT) group exert superiority in both OS and DFS compared to no HSCT group with 2-year of follow-up（p＜0.0001 and p＜0.00001 respectively）. Image:Summary/Conclusion: In conclusion, CLAG + PLD is a prospective salvage regimen for r/r AML which brings improved response rates, 2-year OS and DFS and similar toxicities compared to CLAG. 

P588: improved outcome of relapsed/refractory acute myeloid leukemia by addition of liposomal adriamycin to clag chemotherapy

The plain-orifice is the most common type of atomizer. The flow regime inside plain-orifice nozzle has a tremendous effect on the external spray. At present, the judgement method of the flow pattern is not uniform. The purpose of this study is to numerically investigate the relationship between the change of flow pattern, the ratio of nozzle length and nozzle diameter (L/d), the ratio of nozzle radius of the entrance and nozzle diameter (r/d) in plain-orifice nozzle. The computational fluid dynamics (CFD) code FLUENT was used to perform the numerical simulation of the cavitating flow and hydraulic flip in the nozzles. In this paper, the relationship between the change of flow pattern, r/d and L/d was obtained, and the relation curves between L/d and r/d were plotted, and a new model of flow pattern was obtained. The model established in this paper is more accurate than the empirical model to judge the change of flow pattern. The new model is helpful to modify the existing empirical model. According to the relationship, the researcher can use the method of reasonably adjusting the relationship between the nozzle structure and operating conditions to avoid the generation of hydraulic flip, and to get better atomization effect.

On flow regime inside plain-orifice nozzle

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P588: improved outcome of relapsed/refractory acute myeloid leukemia by addition of liposomal adriamycin to clag chemotherapy

On flow regime inside plain-orifice nozzle