Myelodysplastic Syndromes,Acute Myeloid Leukemia Clinical Trial
Official title:
An Randomized Controlled Study of Azacitidine Combined With Homoharringtonine Compared With Azacitidine for Patients With Int/High -Risk MDS and AML-MRC
evaluate the clinical efficacy and safety of azacitidine combined with HAG regimen for patients with int/high -risk MDS and AML-MRC with less than 30% blasts compared with azacitidine
Myelodysplastic syndromes (MDS) is a group of heterogeneous clonal diseases originating from
hematopoietic stem cells. The most common types of acute myeloid leukemia (AML) are AML with
myelodysplasia-related changes (AML-MRC) and AML-NOS. AML-MRC patients are usually with
multilineage pathological hematopoiesis, previous history of MDS or MDS-related cytogenetic
abnormalities. Compared with AML-NOS, AML-MRC patients are usually older, with poor prognosis
of cytogenetic changes, low remission rate of chemotherapy, and worse overall prognosis. The
treatment strategies mainly include demethylation drugs, chemotherapy and allogeneic
hematopoietic stem cell transplantation. The main purpose of treatment is to delay disease
progression, prolong survival, and even be cured.
Epigenetic changes such as DNA methylation and histone deacetylation have been considered to
be involved in the occurrence and development of MDS. Demethylation drugs, such as
5-azacitidine (AZA) and 5-aza-2-deoxycytidine (decitabine), can inhibit DNA
methyltransferase, reduce excessive methylation of tumor suppressor genes, promote cell
differentiation and apoptosis, and play an anti-tumor role. Demethylation drugs are important
therapy for MDS patients. Compared with supportive treatment, demethylation drugs can reduce
the risk of AML progression and improve survival.
Therefore, we proposed this project in order to further clarify the role of azacytidine in
therapy for high-risk and middle-risk MDS and AML-MRC patients, and evaluate its clinical
efficacy, to explore the optimal azacytidine treatment strategies for high-risk and
middle-risk MDS and AML-MRC patients.
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