decitabine + cytarabine + aclarubicin + filgrastim + HLA mismatched mononuclear cell

This therapeutic regimen is a combination chemo-immunotherapy protocol developed primarily by the Department of Hematology at Tangdu Hospital for the treatment of acute myeloid leukemia (AML), particularly in elderly or relapsed/refractory patient populations. The regimen, often referred to as **D-CAG-MST**, integrates the D-CAG chemotherapy backbone with **microtransplantation** (MST). **Decitabine** acts as a hypomethylating agent to provide epigenetic priming, potentially sensitizing leukemia cells to subsequent chemotherapy. The **CAG** component consists of **cytarabine** (an antimetabolite), **aclarubicin** (an anthracycline topoisomerase II inhibitor), and **filgrastim** (G-CSF). Filgrastim is used to prime quiescent leukemia cells into the S-phase of the cell cycle, making them more susceptible to the cytotoxic effects of cytarabine and aclarubicin. The final component, **HLA-mismatched donor mononuclear cells**, provides a transient graft-versus-leukemia (GVL) effect. Unlike traditional hematopoietic stem cell transplantation, microtransplantation does not require intensive conditioning or graft-versus-host disease (GVHD) prophylaxis, as the donor cells do not permanently engraft, thereby reducing treatment-related mortality while enhancing anti-leukemic activity.

Other names

Decitabine-CAG plus microtransplantationD-CAG plus HLA-mismatched donor mononuclear cell infusionD-CAG plus MST