Low dose of homoharringtonine and cytarabine combined with G-CSF for treatment of acute myelocytic leukemia: report of 28 cases

Objective: To explore the clinical effect of low dose of homoharringtonine(HHT) and cytarabine(Ara-c) combined with granulocyte colony-stimulating factor(G-CSF) (HAG regimen) in treating acute myelocytic leukemia(AML).Methods: Twenty-eight patients with AML including 3 cases of M1,10 cases of M2a,1 case of M2b,2 cases of M4,8 cases of M5 and 4 cases of myelodysplas-ticsyndrome(MDS) were treated with HAG regimen.HHT 1 mg/d intravenous infusion and Ara-c 25-50 mg/d intravenous infusion were administered from 1st to 14th day;G-CSF 150-300 μg/d was injected subcutaneously.If the white blood cell count rose to 20×10⁹/L,G-CSF was suspended until the WBC dropped to normal.Results: Complete remission(CR) and partial remission(PR) were observed in 22 of the total 28 cases(78%).Among the 15 CR cases,4 had received mitoxantrone and cytarabine,pirarubicin and cytarabine regimen for two cycles before but had achieved no remission.Ten of the 28 cases were elderly AML(≥ 60 years),and CR was noted in 7 of them.Conclusions: The regimen of low dose of homoharringtonine and cytarabine in combination with G-CSF is effective for patients with relapsed and/or secondary acute myeloid leukaemia,especially the elderly.