Prospective multicentre study of chemotherapeutic regimen containing pirarubicin on the treatment of relapsed or refractory acute myeloid leukemia in adults / 中华血液学杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of the chemotherapeutic regimen containing pirarubicin and mitoxantrone on the treatment of relapsed or refractory acute myeloid leukemia (AML) in adults.</p><p><b>METHODS</b>In this open prospective multicentre study, we randomly assigned patients with relapsed or refractory AML to receive TAE regimen (pirarubicin+cytarabine+etoposide) versus MAE regimen (mitoxantrone + cytarabine + etoposide). The efficacy and toxicity were compared between the two groups.</p><p><b>RESULTS</b>56 patients entered this clinical trial. The complete remission (CR) rate on TAE arm was 79.0% versus 55.6% on MAE arm with the overall response (OR) rates of 86.8% versus 88.9%, respectively. The CR was higher on TAE arm (P=0.035) but with no significant difference between the two groups regarding the overall response (OR) rate. The regimens were well tolerated in both groups. Hematologic and non-hematologic toxicity were similar except relatively lower the mean dosage of G-CSF, red blood cells and platelets transfusion on TAE arm. No significant differences were seen between the two groups regarding the overall survival and relapse free survival rates.</p><p><b>CONCLUSION</b>TAE regimen might be an effective salvage therapy in patients with relapsed or refractory AML.</p>

Demethylation stduy of decitabine in acute leukemia patients with Apaf-1 gene methylated / 白血病·淋巴瘤

Objective To investigate the effectiveness of decitabine demethylation in treatment of acute leukemia.Methods Methylation specific PCR (MSP) was used to detected the methylation status of Apaf-1 gene promoter.10 cases entering the group.MSP was used to detected the 10 cases methylation status of Apaf-1 promoter between pre-and post-treatment of dicitabine.RT-PCR method used was to detect the differential expression levels of Apaf-1 mRNA in acute leukemia bone marrow mononuclear cell between preand post-treatment of decitabine.Results In post-treatment of decitabine,6 cases Apaf-1 gene promoter was demethylated.The loss expression of Apaf-1 mRNA re-expressed in 4 cases.6 cases Apaf-1 mRNA still express deletion.6 cases patients have Apaf-1 mRNA exprssion deletion,However,4 cases Apaf-1 gene was demethylated,2 cases methylated in post-treatment,maybe related to allele deletion or allelic varriants.Conclusion Post treatment of decitabine.Apaf-1 gene promotor was demethylated and repress the expression of Apaf-1 mRNA,play a key role in apoptosis maybe a new method for treatment of acute leukemia.