Efficacy and safety of an HDACi- and HMA-based protocol in adults with acute myeloid leukemia of intermediate- and adverse-risk categories: a retrospective study
Zhibo Guo,
Dan Guo,
Desheng Kong,
Sicheng Bian,
Leilei Lin,
Shengjin Fan,
Qi Li,
Yanqiu Zhao,
Yanmeng Jiang,
Jiangrong Yan,
Zheren Wang,
Lili Sun,
Yinghua Li
Affiliations
Zhibo Guo
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Dan Guo
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Desheng Kong
Department of Hematology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Sicheng Bian
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Leilei Lin
Department of Hematology, Yantai Yuhuangding Hospital, Qingdao University Medical College, Yantai, People’s Republic of China
Shengjin Fan
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Qi Li
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Yanqiu Zhao
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Yanmeng Jiang
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Jiangrong Yan
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Zheren Wang
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Lili Sun
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
Yinghua Li
Department of Hematology, The First Affiliated Hospital, Harbin Medical University, Harbin, People’s Republic of China
ABSTRACTObjective Anthracyclines and cytarabine have comprised standard induction therapy for acute myeloid leukemia (AML) for decades. Low overall survival of AML is due to non-remission or relapse after remission. Hypomethylating agent (HMA) decitabine combined with low-dose chemotherapy or other targeted agents has shown promising effect for AML in clinical trials, especially in t(8;21) acute myeloid leukemia. We previously investigated histone deacetylase inhibitor (HDACi) chidamide could regulate Wnt/β-catenin signaling pathway in leukemia cell lines.Methods Adult patients with de novo or relapsed/refractory AML who were treated with chidamide and decitabine in combination with chemotherapy (chidamide group, n = 23) or only decitabine combination with chemotherapy (decitabine group, n = 17) were analyzed.Results Chidamide group represented higher complete response rate (82.6% and 52.9%, p = 0.0430, vs. decitabine group), progression-free survival and overall survival rates (p = 0.0088 and p = 0.0139, respectively), especially for patients with de novo AML. Hematological toxicity and infections were the most common adverse events (AEs) in both groups, and they were manageable by supportive treatments.Conclusions This HDACi- and HMA-based protocol is an effective and tolerable therapy for patients with AML. The comprehensive mechanism and effects of chidamide in combination with decitabine are worth to be further explored in AML.
