Remission induction in acute myeloid leukemia
Inducing a complete remission (CR) in patients with acute myeloid leukemia is a prerequisite to long-term disease control with subsequent post-remission consolidation chemotherapy or allogeneic hematopoietic stem cell transplantation. The use of 7 days of infusional cytarabine and 3 days of daunorubicin or idarubicin (7 + 3) has become the standard of care to induce CR, based on clinical trials conducted in the 1980s. Efforts to improve on the CR rate seen with the 7 + 3 regimen that translates into better overall patient survival have been disappointing. Here we review recent phase III studies of novel induction strategies that show promise in increasing the rate of CR and improving disease outcome.
- Preisler H, et al. Comparison of three remission induction regimens and two postinduction strategies for the treatment of acute nonlymphocytic leukemia: a cancer and leukemia group B study. Blood. 1987;69(5):1441–9.
- Yates J, et al. Cytosine arabinoside with daunorubicin or adriamycin for therapy of acute myelocytic leukemia: a CALGB study. Blood. 1982;60(2):454–62.
- Rai KR, et al. Treatment of acute myelocytic leukemia: a study by cancer and leukemia group B. Blood. 1981;58(6):1203–12.
- Fernandez HF, et al. Anthracycline dose intensification in acute myeloid leukemia. N Engl J Med. 2009;361(13):1249–59. CrossRef
- Patel JP, et al. Prognostic relevance of integrated genetic profiling in acute myeloid leukemia. N Engl J Med. 2012;366(12):1079–89. CrossRef
- Lowenberg B, et al. High-dose daunorubicin in older patients with acute myeloid leukemia. N Engl J Med. 2009;361(13):1235–48. CrossRef
- Lee JH, et al. A randomized trial comparing standard versus high-dose daunorubicin induction in patients with acute myeloid leukemia. Blood. 2011;118(14):3832–41. CrossRef
- Ohtake S, et al. Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia: the JALSG AML201 Study. Blood. 2011;117(8):2358–65. CrossRef
- Holowiecki J, et al. Cladribine, but not fludarabine, added to daunorubicin and cytarabine during induction prolongs survival of patients with acute myeloid leukemia: a multicenter, randomized phase III study. J Clin Oncol 2012.
- Burnett AK, et al. Identification of patients with acute myeloblastic leukemia who benefit from the addition of gemtuzumab ozogamicin: results of the MRC AML15 trial. J Clin Oncol. 2011;29(4):369–77. CrossRef
- Castaigne S, et al. Effect of gemtuzumab ozogamicin on survival of adult patients with de novo acute myeloid leukaemia (ALFA-0701): a randomised, open-label, phase 3 study. Lancet. 2012;379(9825):1508–16. CrossRef
- Remission induction in acute myeloid leukemia
International Journal of Hematology
Volume 96, Issue 2 , pp 164-170
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