Objective  To investigate the clinical efficacy of trimetazidine combined with low-dose cytarabine+aclarubicin+granulocyte colony-stimulating factor (CAG) regimen in elderly patients with acute myeloid leukemia (AML) complicated with pulmonary infection, and to analyze its clinical efficacy and safety.

Methods  A retrospective analysis was conducted on the data of elderly AML patients with pulmonary infections admitted to the Lishui Central Hospital from April 2022 to September 2024. The patients were divided into a control group (low-dose CAG regimen) and an observation group (CAG combined with trimetazidine), with a treatment course of 60 days. The clinical efficacy, blood indicators, immune function, acute Leukemia Patient Reporting Clinical Outcome Scale (ALPRO), and adverse reactions of the two groups were observed.

Results  A total of 105 AML patients were included, 59 in the observation group and 46 in the control group. The objective remission rate of the observation group was higher than that of the control group (89.83% vs. 73.91%, P<0.05), and the overall survival and progression free survival of the observation group were longer than those of the control group (P<0.05). The white blood cell count, platelet count, and NK cell level in the observation group were higher than those in the control group, but the proportion of bone marrow primitive cells ratio, CD4⁺/CD8⁺, regulatory T cells levels was lower than that of the control group (P<0.05). The ALPRO scores in the physiological, psychological, therapeutic, and social support areas of the observation group were higher than those of the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion  The combination of trimetazidine and low-dose CAG regimen is efficacious in elderly patients with AML combined with pulmonary infection. It improves the peripheral blood count and immune function of the patients, enhances their quality of life, and has good safety.

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