TY - JOUR
T1 - Effectiveness of homoharringtonine (omacetaxine mepesuccinate) for treatment of acute myeloid leukemia
T2 - A meta-analysis of Chinese studies
AU - Kantarjian, Hagop
AU - O'Brien, Susan
AU - Jabbour, Elias
AU - Barnes, Gisoo
AU - Pathak, Ashutosh
AU - Cortes, Jorge
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015
Y1 - 2015
N2 - The present meta-analysis provides an overview on the effectiveness of homoharringtonine (HHT) combination regimens to treat acute myeloid leukemia (AML). Because most of these studies were performed in China, Chinese published clinical studies were used for the analysis. A search for studies from 2006 to 2013 of regimens containing HHT for AML treatment was performed using published studies and Chinese databases in Mandarin. The complete response (CR) and overall response (OR) rates were analyzed, and the fixed effects model and random effects model (REM) were calculated. The heterogeneity of the studies was calculated using Q homogeneity statistics. The metaanalysis included 21 studies (n = 1310, n = 229 pediatric, and n = 216 elderly). HHT was given in combination with cytarabine, daunorubicin, idarubicin, aclacinomycin, mitoxantrone, or granulocyte colony-stimulating factor. Heterogeneity was seen in all analyzed pools, but it was most pronounced in retrospective studies. Overall, the REM showed a CR rate of 65.2%. However, in studies in which HHT-containing regimens were compared to regimens without HHT, the CR rates were 69.1% in randomized trials and 62.8% in retrospective studies. Additionally, in studies with exclusively elderly patients, the CR rate was considerably lower than it was for the studies with mixed age populations (47.5% vs. 65.2%). Higher overall CR rates for HHT-containing regimens in AML treatment in the Chinese studies suggest that HHT could be an active agent in the management of AML. Additional clinical trials are warranted to evaluate the efficacy of HHT in AML treatment.
AB - The present meta-analysis provides an overview on the effectiveness of homoharringtonine (HHT) combination regimens to treat acute myeloid leukemia (AML). Because most of these studies were performed in China, Chinese published clinical studies were used for the analysis. A search for studies from 2006 to 2013 of regimens containing HHT for AML treatment was performed using published studies and Chinese databases in Mandarin. The complete response (CR) and overall response (OR) rates were analyzed, and the fixed effects model and random effects model (REM) were calculated. The heterogeneity of the studies was calculated using Q homogeneity statistics. The metaanalysis included 21 studies (n = 1310, n = 229 pediatric, and n = 216 elderly). HHT was given in combination with cytarabine, daunorubicin, idarubicin, aclacinomycin, mitoxantrone, or granulocyte colony-stimulating factor. Heterogeneity was seen in all analyzed pools, but it was most pronounced in retrospective studies. Overall, the REM showed a CR rate of 65.2%. However, in studies in which HHT-containing regimens were compared to regimens without HHT, the CR rates were 69.1% in randomized trials and 62.8% in retrospective studies. Additionally, in studies with exclusively elderly patients, the CR rate was considerably lower than it was for the studies with mixed age populations (47.5% vs. 65.2%). Higher overall CR rates for HHT-containing regimens in AML treatment in the Chinese studies suggest that HHT could be an active agent in the management of AML. Additional clinical trials are warranted to evaluate the efficacy of HHT in AML treatment.
KW - China
UR - http://www.scopus.com/inward/record.url?scp=84934282413&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84934282413&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2014.09.011
DO - 10.1016/j.clml.2014.09.011
M3 - Review article
C2 - 25458084
AN - SCOPUS:84934282413
SN - 2152-2650
VL - 15
SP - 13
EP - 21
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 1
ER -