Effects of Different Chemotherapy Regimens on Short-Term Efficacy, Survival Time and Adverse Reactions in Patients With Acute Myeloid Leukemia After Initial Induction Failure

Objective To investigate the effects of different chemotherapy regimens on short-term efficacy, survival and adverse reactions in patients with acute myeloid leukemia （AML） after initial induction failure. Methods 120 cases of AML patients after initial induction failure were retrospectively included in Huabei Petroleum Administration Bureau General Hospital from January 2017 to December 2019. According to different treatment regimens, they were divided into FLAG regimen fludarabine （Flud） combined with cytarabine （Ara-C） and granulocyte colony stimulating factor （G-CSF） group, CAG regimen aclarubicin （Acla） combined with Ara-C and G-CSF group, and MAC regimen mitoxantrone （MTZ） combined with cyclophosphamide （CTX） and Ara-C group, with 40 cases in each group. The short-term efficacy, survival time and adverse reactions were compared among the three groups. Results The complete response （CR） rate of MAC regimen group was significantly higher than that of FLAG regimen group and CAG regimen group （52.50% vs. 32.50%, 35.00%, P<0.05）, overall response rate （OR） was significantly higher than that of FLAG regimen group （65.00% vs. 42.50%, P<0.05）. There was no significant difference on partial response （PR） among the three groups （P>0.05）. The overall survival （OS） of MAC regimen group was significantly higher than that of FLAG regimen group and CAG regimen group 32.6 months （2.0~47.5） vs. 19.7 months （1.5~28.4）, 13.0 months （1.6~25.2）, P<0.05. There was no significant difference on disease free survival （DFSP among the three groups （P>0.05）. The incidence of infection of MAC regimen group and CAG regimen group was significantly higher than that of FLAG regimen group （82.50%, 77.50% vs. 50.00%, P<0.05）. There was no significant difference on incidence of other adverse reactions among the three groups （P>0.05）. Conclusions MAC regimen could significantly improve the short-term efficacy and survival time of AML patients after initial induction failure, while the incidence of infection was higher, but not serious adverse reactions, and the overall value was relatively higher than FLAG regimen and CAG regimen.