Table 1.

Summary of clinical data and results of the therapy of patient No. 2. and No. 3.

Sex Age	Male Patient. 74 Years Patient No. 2	Male Patient. 54 Years Patient No. 3
Diagnosis	AML without maturation (NOS, WHO 2016). Intermediate risk group (ELN2017). Normal karyotype. Primary refractory disease.	AML with maturation (NOS, WHO 2016). Add (21) (q22). Intermediate risk group (ELN2017). Primary refractory disease.
Clinical data	A patient with a progression disease during the treatment by azacitidine. Increasing blast cells in blood and marrow by more than 50% from baseline after 2 cycles of azacytidine therapy.	A patient with a progression disease during the treatment by azacitidine. Increasing blast cells in blood and marrow by more than 50% from baseline after 2 cycles of azacytidine therapy.
Patient status before GO therapy initiation	The WHO performance status of 3. Marrow blast cells 88.6%, peripheral blood blast cells 60%, pancytopenia grade 3–4. CRP was slightly increased to 20 mg/L. Acute kidney failure grade 2 with no prior history of chronic kidney disease dehydration, use of nephrotoxic agents or tumor lysis syndrome signs. Creatinine increasing up to 2.8xULN and GFR decline to 15 mL/min.	The WHO performance status of 3. Marrow blasts cells 68%. High fever and elevated CRP level up to 332 mg/L with no response to escalated antibiotics/antimycotics combination. The patient had respiratory failure grade 2 with massive bilateral polysegmental lung infiltrates according to a chest CT scan.
Regimen of therapy with GO	«GO » 1 cycle «GO+Aza» 1 cycle	«GO » 1 cycle
Response to therapy	The WHO performance status improved to grade 2.	The WHO performance status improved to grade 2. Apyrexia was achieved on day 3 of the GO therapy.
	Kidney function began to improve immediately after GO infusion. Creatinine started to decrease on day 1 of the therapy and returned to normal value on day 6 (GFR elevated up to 72 mL/min on day 6). Thus, recovery after acute kidney injury occurred on day 6. There was blast clearance in peripheral blood on day 5 after GO therapy.	CRP level started to drop on day 1 of the therapy (CRP on day 2—250 mg/L, on day 7—60 mg/L)
	On day 5 after GO infusion «GO+Aza» therapy was initiated. No laboratory signs of kidney injury were noticed during whole period of therapy in the «GO+Aza» regimen.	A chest CT scan on day 6 of the GO therapy showed a significant regression of pulmonary infiltrates in the size.
	Day 14 marrow blast cells 16.1%.	Day 7 marrow blast cells 46%. Thus, blast cell reduction was achieved on day 7 after GO infusion.
	Peripheral blood cell recovery was achieved on day 40 of the «GO+Aza» therapy. On day 40 the marrow blast cell was 1%. Thus, complete remission with peripheral blood cell recovery was achieved.	Patient became eligible for chemo intensification. On day 12 of the therapy, “7+3” was initiated.