Objective      To evaluate the clinical efficacy and safety of decitabine (DAC) in combination with HAAG regimen [homoharringtonine (HHT)

cytarabine (Ara-C)

doxorubicin (Acla) and recombinant human granulocyte colony stimulating factor (G-CSF)] for advanced patients with acute myeloid leukemia (AML).       Methods      Thirty-six patients with advanced AML receiving DAC combined with HAAG chemotherapy in our institute from December 2012 to August 2015 were enrolled in this study. Eighteen of them were refractory or relapsed AML

and another 18 patients were those who didn’t achieve complete remission (CR) after a course of induction chemotherapy. The therapeutic responses

side effects and long-time survival were retrospectively analyzed.       Results      After a course of treatment

the rate of CR and partial response (PR) was 58.3% (21/36) and 22.2%（8/36）respectively

while the overall response rate (ORR) was 80.6% (29/36) in the cohort. For the patients with refractory or relapse AML

CR was 61.0%(11/18)

PR was 22.2% (4/18)

and ORR was 83.3% (15/18). While for the other not getting CR after a course of induction chemotherapy

CR was 55.6%(10/18)

PR was 22.2% (4/18)

and ORR was 77.8% (14/18). Grade 4 hematological toxicities were observed in all patients

and 72.2% cases experienced infection. And all side effects were mild and well-tolerated. In the end of median 7.5 (0.5～33.3) months’ follow-up

the 1-year overall survival (OS) rate was 43.3%

24.2% for the refractory or relapsed AML patients

and 61.6% for those not achieving CR after a course of induction chemotherapy

with significant differences (P=0.01).       Conclusion      DAC combined with HAAG regimen is safe and effective for advanced AML patients with less side effects.