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ATRA粒细胞分化诱导剂，VD3单核细胞分化诱导剂 * Treatment Cohorts of sequential subjects were treated with escalating doses of decitabine prior to a standard, “7+3” induction chemotherapy using infusional cytarabine (100 mg/m2/day continuous IV infusion for seven consecutive days) with daunorubicin (60 mg/m2 daily for 3 days, generally, the first three days of cytarabine). Because prior studies suggest that the hypomethylating activity of decitabine plateaus at 20 mg/m2/day 19, we escalated the total decitabine dose delivered by increasing the treatment duration rather than the daily dose. Decitabine was administered at one of three total dose levels: Level 1, three days of decitabine priming (total dose delivered 60 mg/m2); Level 2, five days of decitabine priming to 100 mg/m2 (total dose delivered 100 mg/m2); and Level 3, seven days of priming (total dose delivered, 140 mg/m2 (Fig. 1). To test whether the delivery schedule of decitabine affects its clinical and hypomethylating activity, we administered decitabine either as a daily 1hr infusion (Arm A) or as a continuous infusion (Arm B). Decitabine has limited stability at ambient temperature but is stable for at least 8 hours at 4-10oC 31. To ensure stability, we chilled the decitabine infusate and changed bags every eight hours during the continuous infusion. Standard “7+3” induction chemotherapy was initiated ~24 hours after starting the last day of decitabine priming. We refer to the first day of 7+3 induction as Day +1 for all cohorts. Subjects received supportive care measures as clinically indicated including standard anti-emetic and antimicrobial therapy. Growth factor support was permitted but was only administered to one subject. Following a single induction cycle, subjects received subsequent therapy at the discretion of their treating physician. * Assessment of Efficacy Of the thirty subjects enrolled, twenty-seven (90%) responded to the single induction cycle of study therapy: 17 CR (57%), 10 PR (33%). All subjects with