Low dose of homoharringtonine and cytarabine combined with granulocyte colony-stimulating factor priming on the outcome of relapsed or refractory acute myeloid leukemia.

BACKGROUND: To explore the effect of low dose of homoharringtonine (HHT) and cytarabine (Ara-c) combined with granulocyte colony-stimulating factor (G-CSF) priming (HAG regimen) on relapsed or refractory acute myeloid leukemia (AML). METHODS: Sixty-seven patients with relapsed or refractory acute myeloid leukemia (AML) were enrolled. All the patients were treated with HAG regimen (HHT 1.5 mg/m(2)/day, 1-14d; Ara-C 7.5 mg/m(2)/12 h, 1-14d; G-CSF 150 µg/m(2)/day, according to the counting of the peripheral white blood cells). Blood cell counting, liver, kidney function, ECG and myocardial enzymes were monitored regularly. RESULTS: Thirty-five of 67 (52.2%) patients achieved complete remission (CR) and 8/67 (11.9%) partial remission (PR). The overall response rate was 64.1%. Myelosuppression was the most frequently observed adverse effect. Sixty of 67 (89.5%) patients suffered from grade 1-4 adverse effects of hematologic toxicity (according to World Health Organization criteria) and non-hematologic toxicity was mild. CONCLUSION: In conclusion, HAG regimen was effective and tolerated well in refractory or relapsed AML. As a promising regimen for relapse or refractory AML, further observations should be made.