PMID- 27706258
OWN - NLM
STAT- MEDLINE
DCOM- 20170620
LR  - 20240327
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 10
DP  - 2016
TI  - HAG (Homoharringtonine, Cytarabine, G-CSF) Regimen for the Treatment of Acute 
      Myeloid Leukemia and Myelodysplastic Syndrome: A Meta-Analysis with 2,314 
      Participants.
PG  - e0164238
LID - 10.1371/journal.pone.0164238 [doi]
LID - e0164238
AB  - BACKGROUND: In China, the combination of homoharringtonine, cytarabine, and G-CSF 
      (HAG) has been extensively applied for treatment of acute myeloid leukemia (AML) 
      and myelodysplastic syndrome (MDS). METHODS: We performed a meta-analysis of 
      2,314 patients (AML, n = 1754; MDS, n = 560) to determine the overall safety and 
      efficacy of this regimen. RESULTS: The complete response (CR) rate of AML 
      patients (53%) was significantly higher than that of MDS/transformed-AML patients 
      (45%; P = 0.007). The CR rate of patients with newly diagnosed AML (62%) was 
      significantly higher than in patients with relapsed/refractory AML (50%; P = 
      0.001). There were no significant difference in CR rates between elderly AML 
      patients (54%) and all AML patients (P = 0.721). When compared with non-HAG 
      regimens for AML/MDS induction therapy, the CR rate of patients treated with HAG 
      was significantly higher than in treated with intensive chemotherapy (P = 0.000). 
      No significant differences in CR rates were observed between patients treated 
      with HAG and those treated with CAG (cytarabine, aclarubicin, G-CSF) regimens (P 
      = 0.073). HAG regimen was well tolerated, with early death (ED) in 2%, grade IV 
      myelosurrpression in 52% and infection in 50%. Reports of ED and rates of 
      myelosuppression were reduced as compared with intensive chemotherapy (P = 0.000 
      and P = 0.000, respectively). CONCLUSION: The HAG regimen is an effective and 
      safe regimen for the treatment of AML and MDS, and appears to be more effective 
      and better tolerated than intensive chemotherapy. Future randomized controlled 
      trials and further meta-analyses are strongly needed to confirm its efficacy and 
      safety, especially in comparison with intensive chemotherapy.
FAU - Xie, Mixue
AU  - Xie M
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Jiang, Qi
AU  - Jiang Q
AD  - Department of Medical Oncology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Li, Li
AU  - Li L
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Zhu, Jingjing
AU  - Zhu J
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Zhu, Lixia
AU  - Zhu L
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Zhou, De
AU  - Zhou D
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Zheng, Yanlong
AU  - Zheng Y
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Yang, Xiudi
AU  - Yang X
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Zhu, Mingyu
AU  - Zhu M
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Sun, Jianai
AU  - Sun J
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Xie, Wanzhuo
AU  - Xie W
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
FAU - Ye, Xiujin
AU  - Ye X
AD  - Senior Department of Haematology, The First Affiliated Hospital, College of 
      Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310003, China.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20161005
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Harringtonines)
RN  - 04079A1RDZ (Cytarabine)
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - 6FG8041S5B (Homoharringtonine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/*administration & 
      dosage/therapeutic use
MH  - Clinical Trials as Topic
MH  - Cytarabine/administration & dosage/therapeutic use
MH  - Female
MH  - Granulocyte Colony-Stimulating Factor/administration & dosage/therapeutic use
MH  - Harringtonines/administration & dosage/therapeutic use
MH  - Homoharringtonine
MH  - Humans
MH  - Leukemia, Myeloid, Acute/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/*drug therapy
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5051946
COIS- The authors have declared that no competing interests exist.
EDAT- 2016/10/06 06:00
MHDA- 2017/06/21 06:00
PMCR- 2016/10/05
CRDT- 2016/10/06 06:00
PHST- 2016/06/13 00:00 [received]
PHST- 2016/09/21 00:00 [accepted]
PHST- 2016/10/06 06:00 [entrez]
PHST- 2016/10/06 06:00 [pubmed]
PHST- 2017/06/21 06:00 [medline]
PHST- 2016/10/05 00:00 [pmc-release]
AID - PONE-D-16-23367 [pii]
AID - 10.1371/journal.pone.0164238 [doi]
PST - epublish
SO  - PLoS One. 2016 Oct 5;11(10):e0164238. doi: 10.1371/journal.pone.0164238. 
      eCollection 2016.