Abstract:

Objective To explore the efficacy and safety of different doses of cytarabine (Ara-C) in FLAG-IDA regimen as induction therapy in children with acute myeloid leukemia (AML). Methods 121 children who newly diagnosed AML from January 2015 to October 2022 were enrolled in this study. Participants were divided into two groups according to the dose of cytarabine used in the FLAG-IDA induction chemotherapy regimen: the standard-dose (SD) group and the high-dose (HD) group. Therapeutic efficacy and toxicity and side effects of the two groups after the induction chemotherapy were compared. Result A total of 121 children with AML were included, 71 males and 50 females, with a median age at first diagnosis of 6.7 (2.6~10.9) years. There were 30 cases in the SD group and 91 cases in the HD group. Compared with the SD group, the CR rate of induction chemotherapy in the HD group was lower, the duration of neutropenia was shorter, and the levels of AST and ALT after chemotherapy were higher, and the difference was statistically significant (P<0.05). There was no statistically significant difference in toxic and side effects between the two groups (P>0.05). The median follow-up time was 37.0 (12.0~46.0) months. The 3-year OS and EFS of the SD group were (91.1±6.0) % and (79.5±8.3) % respectively, and the 3-year OS and EFS of the HD group were (64.5±11.5) %and (57.5±10.7) % respectively. There was no statistically significant difference in 3-year OS and EFS between the two groups (P>0.05). Conclusion Standard-dose cytarabine can obtain better efficacy and less side effects in induction chemotherapy.

Key words: acute myeloid leukemia, cytarabine, efficacy, child