Effect of induction cytarabine dose intensity on long-term survival in acute myelogenous leukemia: results of a randomized, controlled study.
The optimal dose and schedule of cytarabine in induction chemotherapy of newly diagnosed acute myelogenous leukemia is not established. We compared the use of cytarabine 200 mg/m2/day by continuous infusion for seven days to an intermediate-dose of cytarabine, 500 mg/m2 every 12 hours for 12 doses. Thirty-seven of 52 patients assigned to conventional-dose cytarabine achieved complete remission (71%) and the actuarial disease-free and overall survival after achieving remission were 22 +/- 16% and 31 +/- 19% respectively. Thirty-seven of 50 patients assigned to intermediate-dose cytarabine achieved remission (74%) and the actuarial disease-free and overall survival after achieving remission were 26 +/- 16% and 39 +/- 18% respectively. There were no statistically significant differences in complete remission rate, actuarial leukemia-free survival or overall survival between the groups. The most significant predictor for survival was age. Actuarial two year leukemia-free survival and overall survival for patients age > 60 were 8 +/- 15% and 20 +/- 19% respectively compared to 36 +/- 14% and 54 +/- 15% for patients age < or = 60 (P = .058 and .01, respectively). Induction regimen did not significantly affect disease free or overall survival for patients under or over age 60. We conclude that intermediate-dose cytarabine did not substantially improve results of induction for newly diagnosed acute myeloid leukemia.
Schiller
G
G
Department of Medicine, UCLA School of Medicine.
Nimer
S
S
Gajewski
J
J
Lee
M
M
Ho
W
W
Territo
M
M
Champlin
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
D003561:Cytarabine