Background The incidence of acute myeloid leukemia (AML) increases with age. The overall prognosis remains poor for older patients. Studies on the efficacy of decitabine, an epigenetic agent, in older patients with AML have reported conflicting results. Materials and Methods For this meta-analysis, we performed a literature search and collected 38 studies (including 3298 patients with AML) to evaluate the role of decitabine in elderly patients with AML. We used complete response (CR) or overall response (OR) rate as indicators of effectiveness. Results Patients treated with decitabine have a higher CR/OR rate than those treated with low-dose cytarabine (CR, 2.60; 95% confidence interval [CI], 1.64-4.14; OR, 4.88; 95% CI, 1.98-12.04) or CAG/HAG (low-dose epirubicin and cytarabine with granulocyte stimulating factor/low-dose homoharringtonine and cytarabine with granulocyte stimulating factor) regimens (CR, 2.53; 95% CI, 1.98-3.23; OR, 2.89; 95% CI, 2.24-3.73). However, patients treated with decitabine had a CR rate equivalent to those treated with intensive chemotherapy (CR, 0.58; 95% CI, 0.28-1.22; P = .15). Use of decitabine in combination with other regimens resulted in a higher CR/OR rate than did use of decitabine alone (P  .05). Conclusion The findings presented in this article show that decitabine is effective and safe for the treatment of older patients with AML.

Decitabine Compared With Conventional Regimens in Older Patients With Acute Myeloid Leukemia: A Meta-Analysis.

Objective To evaluate the clinical efficacy and safety of low dose HAG regimen combined with dexcitabine in the treatment of 25 elderly patients with acute myeloid leukemia. Methods The clinical data on 25 elderly patients with acute my－eloid leukemia treated between August 2015 and December 2016 was retrospectively analyzed and divided into the control group and observation group according to treatment methods. The patients in the control group were treated with traditional MA regi－mens, while those in the observation group were treated with a low-dose HAG regimen combined with dicitabine. The clinical effects of the two groups were analyzed. Results The total effective rate of the observation group was 76. 92 and that of the control group was 50. 00. The total effective rate of the observation group was higher than that of the control group, but there was no sig－nificant difference between the two groups (P>0. 05). Before treatment, there was no significant difference in the level of LDH between the two groups (P>0. 05). After treatment, the levels of CD4 CD4/CD8+ ANC in the observation group were signifi－cantly higher than those in the control group (P<0. 05). There was no significant difference in adverse reactions, such as nausea and vomiting, cardiac toxicity, hematological toxicity and hepatorenal toxicity, between the two groups (P>0. 05). Conclusion The low dose HAG regimen combined with dietabine in the treatment of elderly patients with acute myeloid leukemia can reduce the level of COX-2 VEGF, improve the immune function of the body. Adverse reactions are mild and it is quite safe.

Efficacy and Safety of Low-dose HAG Regimen Combined with Dietabine in the Treatment of 25 Elderly Patients with Acute Myeloid Leukemia

Objectives
To explore the differences in therapeutic efficacy between decitabine combined with low dose HAG(D+ HAG)and CAG in elderly patients with acute myeloid leukemia(AML).


Methods
Totally 32 elderly patients with AML in our department from July 2012 to July 2015 were retrospectively analyzed.15 patients were on a therapy of decitabine combined with low dose HAG, and 17 patients with CAG.Efficacy and side effects were compared between the two groups.


Results
In(D+ HAG)versus CAG groups, the complete remission(CR)was 10 cases(66.7%)vs.6 cases(35.3%), partial remission(PR)was 2 cases(13.3%)vs.1 case(5.9%), non-remission(NR)was 3 cases(20%)vs.10 cases(58.8%), and the total efficacy rate(CR+ PR)was 80%vs.41.2%(P 0.05).


Conclusions
The treatment of decitabine combined with low dose of HAG is prior to CAG, and the side effects are all tolerated.So decitabine combined with low dose of HAG can be served as the first-line therapy for elderly AML patients.


Key words: 
Leukemia, myloid; Antineoplastic combined chemotherapy protocols

Comparison of therapeutic efficacy between decitabine combined with low dose HAG and CAG in elderly patients with acute myeloid leukemia

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Comparison of therapeutic efficacy between decitabine combined with low dose HAG and CAG in elderly patients with acute myeloid leukemia