Clinical Comparative Observation of HIA and IA Regimen in Initial Treatment of Newly Diagnosed Acute Myeloid Leukemia

Objective Newly diagnosed acute myeloid leukemia patients were initially treated with conventional IA regimen and dual induction chemotherapy of HIA consisting of idamycin (IDA) regimen and HA ［homoharringtonine (HH) + cytosine arabinoside］ regimen.Therapeutic effects and adverse effects of two regimens also were studied. Methods Forty-three patients were recruited into the HIA group (IDA 7 mg/(m²·d), Day 1-3; HH 2.5 mg/(m²·d), Day 1-5; Ara-C 100 mg/(m²·d), Day 1-5) and 30 patients into the IA group(IDA 10 mg/(m²·d), Day 1-3; Ara-C 100 mg/(m²·d), Day 1-5). Results Complete remission (CR) rate was 74.4% (32/43) in HIA group and 73.3% (26/30) in IA group in the first course.9 patients relapsed during follow-up (1 early relapse and 8 late relapses)in patients achieved CR of HIA group,and 8 patients relapsed (5 early relapse and 3 late relapses) in IA group.No significant differences were observed between the two groups in terms of CR rate and survival. However,the incidence of heart adverse effects was significantly lower in HIA group (2.3%) than that in the IA group (16.7%). The adverse effects in HIA regimen were mainly infections resulted from bone marrow depression (BMD) and no serious non-hematopoietic system adverse effects and particularly aggravate cardiotoxicity were observed.No early death happened during the treatment course. Conclusion HIA regimen had acceptable effects and not aggravating cardiotoxicity although the dosage of anthracyclines was decreased.