Journal
ONCOTARGET
Volume 8, Issue 32, Pages 53654-53663Publisher
IMPACT JOURNALS LLC
DOI: 10.18632/oncotarget.11183
Keywords
decitabine; haploidentical lymphocyte infusion; Induction therapy; acute myeloid leukemia
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Funding
- National Natural Science Foundation of China [81170518, 81270611, 81370635, 81350004, 81470010]
- Capital Medical Development Scientific Research Fund [SF2001-5001-07]
- National Public Health Grant Research Foundation [201202017]
- capital of the public health project [Z111107067311070]
- Inovation and Fostoring Foundation of China PLA Navy General Hospital [cxpy201302]
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In this study, we first initiated a multicenter, single-arm, phase-II clinical trial using decitabine (DAC) (20mg/m(2) for five days) based chemotherapy, followed by haploidentical lymphocyte infusion (HLI) that was applied as induction therapy for elderly patients with AML. Furthermore, the role of HLI infusion was explored in a mouse model. The clinical trial included 29 elderly patients (median age: 64, range 5777) with AML. Sixteen cases achieved complete remission (CR) and 9 cases achieved partial remission (PR) after the first treatment cycle. Of the patients with PR, 5 subjects achieved remission after the second induction, which brings the overall CR rate to 72.4%. The 2-year overall survival (OS) and disease-free survival (DFS) was 59.6% and 36.9% respectively. The treatment regimen was well tolerated with only one patient died of severe pneumonia one month after the first treatment. In the mouse experiment, we found that DAC/HLI significantly enhanced the survival of leukemic mice. These results suggested that DAC-based chemotherapy combined with HLI is an alternative first line induction therapy for elderly patients with AML.
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