Glasdegib tablets combined with low-dose cytarabine is a standardized regimen for the treatment of newly diagnosed acute myeloid leukemia (AML), which requires strict adherence to a 28 day dosing cycle. This plan needs to pay attention to special risks such as QT interval prolongation and embryonic toxicity, and establish emergency management mechanisms for serious side effects such as bleeding and arrhythmia.

1. Composition of combination therapy plan

Grassib tablets 100mg orally daily for 28 days, combined with subcutaneous injection of 20mg cytarabine (twice daily from day 1-10 of each cycle). The treatment should last for at least 6 cycles, and if there is no unacceptable toxicity, it should continue until the disease progresses.

2. Medication operation specifications

(1) Grasse cloth sheet

The whole tablet should be swallowed and cannot be divided into small pieces. It should be taken at a fixed time every day, and the food should not affect absorption. After vomiting, do not take it again. If missed, take it again 12 hours before the next dose, and repeat administration is prohibited within 12 hours.

(2) Cytarabine

Subcutaneous injection requires rotating the injection site to avoid repeated injections in the same area. Before injection, check the transparency of the solution. If there is turbidity or precipitation, it should be discarded.

3. Grading management of adverse reactions

(1) Urgent treatment of symptoms is required

If black stool/hematuria, chest pain/arrhythmia, consciousness disorders/epilepsy, persistent fever, etc. occur, stop taking medication immediately and seek medical attention, which may indicate bleeding, cardiac toxicity, or severe infection.

(2) Routine monitoring items

During the treatment period, weekly monitoring of electrocardiogram (QT interval), blood routine, and CPK levels is required. If muscle pain or elevated CPK occurs, monitoring frequency should be increased.

4. Precautions for special populations

(1) Reproductive risk control

The pregnancy test should be negative within 7 days before medication, and effective contraception should be used during the treatment period and 30 days after the last dose. Men should use condoms to prevent exposure to semen drugs.

(2) Patients with renal insufficiency

Severe kidney damage (eGFR15-29mL/min) does not require dose adjustment, but requires enhanced electrocardiogram monitoring to be alert to the risk of arrhythmia caused by QT prolongation.

5. Drug interactions

Avoid using potent CYP3A inhibitors/inducers in combination, and adjust the dosage when necessary. Caution should be exercised when using QT prolonging drugs in combination, and it is recommended to administer them intermittently and strengthen electrocardiogram monitoring.