Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis

Objectives A combination of hypomethylation agents (HMA) and the HAG regimen (homoharringtonine, cytarabine, G-CSF) shows promise as a treatment for Acute Myeloid Leukemia (AML). Nevertheless, the clinical efficacy of this combined therapy in contrast to the HAG regimen alone remains uncertain.Metho...

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Main Authors: Jun Li, Shuying Fu, Chunmei Ye
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2024.2439054
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author Jun Li
Shuying Fu
Chunmei Ye
author_facet Jun Li
Shuying Fu
Chunmei Ye
author_sort Jun Li
collection DOAJ
description Objectives A combination of hypomethylation agents (HMA) and the HAG regimen (homoharringtonine, cytarabine, G-CSF) shows promise as a treatment for Acute Myeloid Leukemia (AML). Nevertheless, the clinical efficacy of this combined therapy in contrast to the HAG regimen alone remains uncertain.Methods We conducted a meta-analysis of eligible studies comparing the clinical efficacy of these two regimens. A total of 38 studies involving 1195 AML patients were included in the analysis.Results Our findings suggest that the combination of hypomethylation agents (HMAs) and the HAG regimen resulted in a superior clinical response for newly diagnosed (ND) AML but not for relapsed/refractory (R/R) AML when compared to the HAG regimen alone. Subgroup analysis revealed that the pairing of azacitidine with the HAG regimen, as opposed to Decitabine with HAG, exhibited a higher response rate for ND AML when compared to the HAG regimen alone. Additionally, the combination of HMAs and the HAG regimen demonstrated good tolerability with a low early mortality rate and manageable adverse effects.Conclusions Our meta-analysis suggests a potential trend towards improved efficacy when Azacitidine is added to the HAG regimen for treating acute myeloid leukemia (AML), especially in elderly or medically unfit patients. However, these findings should be interpreted as suggestive rather than definitive, emphasizing the need for further studies to confirm these preliminary results.
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spelling doaj-art-8604ad81da074dd689fc1441cc67d2b32025-08-20T01:59:09ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2439054Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysisJun Li0Shuying Fu1Chunmei Ye2Department of Hematology, Taixing People’s Hospital Affiliated to Yangzhou University, Taixing, People’s Republic of ChinaDepartment of Hematology, Taixing People’s Hospital Affiliated to Yangzhou University, Taixing, People’s Republic of ChinaDepartment of Hematology, Taixing People’s Hospital Affiliated to Yangzhou University, Taixing, People’s Republic of ChinaObjectives A combination of hypomethylation agents (HMA) and the HAG regimen (homoharringtonine, cytarabine, G-CSF) shows promise as a treatment for Acute Myeloid Leukemia (AML). Nevertheless, the clinical efficacy of this combined therapy in contrast to the HAG regimen alone remains uncertain.Methods We conducted a meta-analysis of eligible studies comparing the clinical efficacy of these two regimens. A total of 38 studies involving 1195 AML patients were included in the analysis.Results Our findings suggest that the combination of hypomethylation agents (HMAs) and the HAG regimen resulted in a superior clinical response for newly diagnosed (ND) AML but not for relapsed/refractory (R/R) AML when compared to the HAG regimen alone. Subgroup analysis revealed that the pairing of azacitidine with the HAG regimen, as opposed to Decitabine with HAG, exhibited a higher response rate for ND AML when compared to the HAG regimen alone. Additionally, the combination of HMAs and the HAG regimen demonstrated good tolerability with a low early mortality rate and manageable adverse effects.Conclusions Our meta-analysis suggests a potential trend towards improved efficacy when Azacitidine is added to the HAG regimen for treating acute myeloid leukemia (AML), especially in elderly or medically unfit patients. However, these findings should be interpreted as suggestive rather than definitive, emphasizing the need for further studies to confirm these preliminary results.https://www.tandfonline.com/doi/10.1080/16078454.2024.2439054Acute myeloid leukemiahypomethylation agentsazacitidinedecitabineHAG regimenmeta-analysis
spellingShingle Jun Li
Shuying Fu
Chunmei Ye
Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
Hematology
Acute myeloid leukemia
hypomethylation agents
azacitidine
decitabine
HAG regimen
meta-analysis
title Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
title_full Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
title_fullStr Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
title_full_unstemmed Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
title_short Effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with HAG priming: a systematic review and meta-analysis
title_sort effect of hypomethylating agents on prognosis in acute myeloid leukemia patients treated with hag priming a systematic review and meta analysis
topic Acute myeloid leukemia
hypomethylation agents
azacitidine
decitabine
HAG regimen
meta-analysis
url https://www.tandfonline.com/doi/10.1080/16078454.2024.2439054
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