Approaches to induction therapy with adult acute myeloid leukaemia.
Induction therapy of acute myeloid leukaemia (AML) with standard-dose chemotherapy will result in approximately 64% of patients achieving a complete remission (CR). New drugs which are active in induction therapy in randomised clinical trials are etoposide, idarubicin and high dose cytarabine. Intensification of induction treatment with etoposide or high-dose cytarabine does not appear to alter the CR rate but prolongs remission and has some impact on survival. High-dose cytarabine in induction combinations increase relapse-free survival compared to standard approaches. These induction results appear to parallel results obtained with post-remission therapies intensified with high-dose cytarabine. These studies provide clinical evidence that intensified induction with cytarabine in AML influences subsequent outcome but is more toxic, gives more profound myelosuppression post-remission and has benefit confined to younger patients.
Bishop
J F
JF
Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, N.S.W., Australia. jbishop@canc.rpa.cs.nsw.gov.au
D000208:Acute Disease; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007951:Leukemia, Myeloid / Q000628:therapy*; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis
D000970:Antineoplastic Agents