To evaluate the efficacy and toxicity of low-dose
cytarabine and
aclarubicin in combination with
granulocyte colony-stimulating factor (
G-CSF) protocol for patients with relapsed
acute myeloid leukemia (AML). A total of fifty relapsed patients have been enrolled, including 13 early relapsed and 37 late relapsed. 24 patients were male and 26 were female, with age ranging from 15 to 69 (median 47) years. Out of them, 7 patients relapsed after allogeneic
peripheral blood stem cell transplantation (allo-PBSCT), 3 patients relapsed after autologous
peripheral blood stem cell transplantation (auto-PBSCT), 25 patients relapsed after received regimens including high dose
cytarabine and 15 patients relapsed after CR or stopping chemical
therapy themself in course of consolidatory
therapy. 30 relapsed patients received
CAG regimen, and 20 patients (control group) received an
anthracycline in combination with
cytarabine. The results indicated that after one course, the complete remission (CR) rate was 46.7% (14/30), the CR rate after allo-PBSCT was 50% (3/6), the early death rate was 3.3% in CAG group; and CR rate was 30% (6/20) and the early death rate was 15% in control group. Myelosuppression was mild to moderate, and no severe nonhematologic toxicity was observed in two groups. The overall median times in CAG group and control group were 22 and 19 months respectively. In conclusion,
CAG regimen as the induction
therapy is effective and well tolerable with low side effects for relapsed patients who had received high dose
cytarabine, auto-PBSCT or allo-PBSCT.