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Azacitidine (AZA) combined with cytarabine was used for newly diagnosed older patients with acute myeloid leukemia (AML). Since 2017, 28 newly diagnosed older AML patients (> 65 years old) had received AZA combined with lowdose cytarabine (LDAC) in our hospital. 9 patients (32%) achieved a CR, 7 (25%) achieved a CRi, and 10 (36%) achieved a PR for an ORR (CR+CRi+PR) rate of 93%. The median PFS and OS were 9.3 months (95% CI 7.55–11.05 months) and 12.6 months (95% CI 8.6–16.6 months), respectively. The 1-year PFS and 1-year OS were 31% and 50%, respectively. Post hoc univariate analysis showed that median OS was longer for patients with secondary AML (16.8 months) and WBC count < 30 x 109/L at onset (16.7 months). AZA plus LDAC could obtain a better effect for the older AML patients ineligible for IC, and would be more suitable for older AML patients in China.