Decitabine combined with low-dose cytarabine, aclarubicin and rhG-CSF regimen may be a potential alternative for relapsed/refractory acute myeloid leukemia: A single-center study

To analyze the effectiveness of decitabine combined with low-dose Ara‑C, aclarubicin, and rhG-CSF (DCAG) as a salvage therapy in patients with relapsed/refractory (R/R) acute myeloid leukemia (AML).

This single-centered retrospective study included patients with relapsed/refractory AML between January 2013 and June 2020. The response rate and survival were calculated, and their correlations with clinical characteristics were estimated.

Thirty-seven patients were enrolled. The overall response rate (ORR) was 56.8% with a complete remission (CR) rate of 51.4%. For patients with non-refractory and refractory AML, the CR rates were 87.5% and 30.4%, respectively (p < 0.001). No remission was found in four primary refractory AML. The incidence of infections was 73%, wherein 13.5% had severe infection, and 2.7% with treatment-related mortality. The median overall survival (OS) and relapse-free survival (RFS) were 10.6 (7.7–13.5) months and 5.0 (2.8–7.2) months, respectively. Patients in the poor risk category had a shorter OS (P = 0.004). The OS and RFS of patients with a recurrence time of < 6 months were shorter (P = 0.018 and P < 0.001, respectively).

The DCAG regimen was an effective and well-tolerated therapeutic alternative for R/R AML, particularly in non-refractory patients. Patients in the poor risk category and early relapse were adverse factors for remission rate and survival.