Abstract
Acute myeloid leukemia (AML) is one of the most prevalent types of acute leukemia in adults, markedly impacting the quality of life, especially in the elderly. The clinical effectiveness of decitabine and the cytarabine, aclarubicin, and granulocyte colony-stimulating factor (GAC) regimen alone in AML patients is limited, and current research on the application of decitabine combined with CAG in AML patients is relatively scarce. This study aimed to analyze the differences in the therapeutic efficacy of CAG regimen alone and in combination with decitabine in patients with AML. A retrospective analysis was conducted on 150 patients with AML who underwent treatment in our hospital from July 2018 to March 2023. They were categorized into two groups based on the differences in their treatment regimens: the CAG group (n = 61, treated with the CAG regimen) and the D-CAG group (n = 89, treated with decitabine in combination with the CAG regimen). Patients of both groups were compared in terms of the therapeutic efficacy, changes in T lymphocyte subsets before and after treatment, differences in IL-4 levels before and after treatment, and occurrences of adverse reactions and toxic side effects during treatment. A 12-month follow-up was conducted for both patient groups, and the cumulative incidence of relapse and cumulative survival rate were compared. The overall response rate of patients in the D-CAG group was 93.26%, which was significantly higher than the 60.66% response rate in the CAG group (P < 0.05). Starting from the 4-month follow-up, the relapse rate in the D-CAG group was lower than that in the CAG group (P < 0.05). After the 12-month follow-up, the cumulative survival rate in the D-CAG group (93.26%; 83/89) was higher than in the CGA group (75.41%; 46/61) (P < 0.05). Except for leukopenia, there were no significant differences in the incidence of toxic side effects between the two groups (P > 0.05). After chemotherapy, patients in the D-CAG group exhibited superior immune markers and inflammatory cytokine levels compared to those in the CAG group (P < 0.05). Compared to the CAG regimen alone, the combination of decitabine and CAG regimen enhanced the therapeutic efficacy in AML patients without significantly increasing adverse reactions or toxic side effects, demonstrating commendable safety. Furthermore, the combined treatment regimen may improve immune function to some extent, potentially playing a positive role in controlling AML progression.