Background Nowadays, the combination of CAG regimen with targeted therapy and immunotherapy has greatly improved the prognosis of AML patients, but there are controversies about the prognostic factors of CAG regimen alone, especially in AML elders.

Objective By investigating the survival status of elder patients who received induction CAG regimen in our hospital at the beginning of this century and analyzing the factors affecting survival, we aim to provide scientific evidence for improving the survival of current patients.

Method The AML elder patients treated with induction CAG regimen including low-dose cytarabine (10 mg/m2 per 12 hours, day 1 to 14), aclarubicin(14 mg/m 2 per day, day 1 to 4), and G-CSF priming (200 ug / m2 per day, day 1 to 14) in Fujian Medical University Union Hospital from January 2001 to December 2009 were involved in this research.

Results Among 92 elderly AML patients, 44 (47.8%) showed clinical efficacy, while 48 (52.2%) experienced treatment failure (including 12 deaths (13.0%)). The main adverse reactions of chemotherapy were bone marrow suppression, with mild non hematological adverse reactions. The median recurrence time was 7 months. The risk factors related efficacy were high blasts, elevated LDH and HBDH.

Conclusion The CAG regimen is suitable for elderly patients and can be used for the treatment of relapsed refractory AML and secondary AML. The CAG regimen has mild non hematological adverse reactions. After chemotherapy, there is a longer bone marrow suppression period and a higher infection rate; The reason for the improved efficacy of CAG regimen in current patients may be related to the effective reduction of tumor burden during induction combined with target or immunotherapy.

The authors have declared no competing interest.

This study was funded by grants from Fujian Province Youth Top Talent Project; National Key R&D Program of China[2022YFC2502704];Fujian Provincial Health Commission Young and Middle-aged Talent Project[2021GGA018];Natural Science Foundation of Fujian Province funding project[2021J01782]to XiaofanLi;

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

by Fujian Medical University Union Hospital Ethical Review Board

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All data produced in the present study are available upon reasonable request to the authors