title: Long-term survival after induction therapy with idarubicin and cytosine arabinoside for de novo acute myeloid leukemia.
abstract: We treated 153 patients with de novo acute myeloid leukemia (AML) with two induction courses of conventional-dose cytosine arabinoside (ara-C) and idarubicin (AIDA) followed by either a third course of AIDA, high-dose ara-C or bone-marrow transplantation. The complete remission (CR) rate for all patients was 63.4%, with a higher CR rate for patients with a normal (versus unfavorable) karyotype (73.2% vs 52.5%; P=0.038). The probability of overall survival (OS) was 30.7% after 5 years (26.3% after 7 years). Improved OS at 5 years could be observed for patients up to 50 years old versus patients older than 50 years of age (37.6% vs 19.9%; P=0.001) and patients with a normal (versus unfavorable) karyotype (42.9% vs 14.1%; P=0.0016). Disease-free survival (DFS) after 5 years was 33.2% for all 97 CR patients and was significantly better for patients with a normal (versus unfavorable) karyotype (44.3% vs 12.3%; P= 0.003). Multivariate analysis revealed that the age for OS (P < 0.02) and the karyotype for both OS (P<0.03) and DFS (P< 0.05) were independent prognostic factors. In conclusion, AIDA is an effective and well-tolerated induction regimen (even in elderly patients) with a 5-year survival of more than 30% when combined with ara-C-containing postremission therapy. The karyotype is the most powerful prognostic factor for predicting the outcome of patients treated with this protocol.
authors: Department of Internal Medicine, University of Essen Medical School, Germany.
authors: M
authors: M
authors: Flasshove
authors: P
authors: P
authors: Meusers
authors: J
authors: J
authors: Schütte
authors: R
authors: R
authors: Noppeney
authors: D W
authors: DW
authors: Beelen
authors: S
authors: S
authors: Sohrab
authors: U
authors: U
authors: Roggenbuck
authors: G
authors: G
authors: Kemmeries
authors: G
authors: G
authors: Brittinger
authors: S
authors: S
authors: Seeber
authors: M E
authors: ME
authors: Scheulen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D003561:Cytarabine / Q000627:therapeutic use* / Q000633:toxicity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use* / Q000633:toxicity; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012074:Remission Induction; D015996:Survival Rate
chemical_list: D003561:Cytarabine; D015255:Idarubicin