decitabine + cytarabine + all-trans retinoic acid + G-CSF

DLAAG is a combination chemotherapy regimen developed by Shanghai Tong Ren Hospital for the treatment of relapsed or refractory acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) with excess blasts. The protocol consists of decitabine (a DNA methyltransferase inhibitor), low-dose cytarabine (an antimetabolite), all-trans retinoic acid (ATRA, a differentiation-inducing agent), and granulocyte colony-stimulating factor (G-CSF). The regimen is designed to exploit synergistic effects: decitabine provides epigenetic priming to sensitize leukemic cells, ATRA induces differentiation in non-M3 AML cells, G-CSF stimulates quiescent blasts to enter the cell cycle, and cytarabine provides targeted cytotoxicity. Clinical evaluation in a Phase 2 study (NCT03356080) has demonstrated efficacy and a manageable safety profile, particularly as a bridging therapy to hematopoietic stem cell transplantation.

Other names

all-transretinoic acid-Shanghai Tong Ren Hospital-acute myeloid leukemia-myelodysplastic syndromeDLAAG protocolDLAAG regimen