title: Intensified daunorubicin in induction therapy and autologous peripheral blood stem cell transplantation in postremission therapy (Double-7 protocol) for adult acute myeloid leukemia.
abstract: To investigate whether an intensified dose of daunorubicin (DNR) in induction therapy and autologous peripheral blood stem cell transplantation (PBSCT) in the postremission period are effective treatments, we used a Double-7 protocol to treat adult patients with de novo acute myeloid leukemia (excluding M0 and M3). Induction therapy consisted of 40 mg/m2 of DNR intravenous drip infusion for 7 days and 200 mg/m2 of ara-C by continuous infusion for 7 days (7 + 7 DC regimen). Patients who achieved complete remission (CR) were given high-dose chemotherapy with autologous PBSCT in postremission therapy. Of the 22 assessable patients, 16 attained CR (73%). Disease-free survival (DFS) and overall survival (OS) at 3 years were 61.2% and 48.1%, respectively. Nine of the CR patients underwent PBSCT without therapy-related mortality. Patients in a favorable cytogenetic group (n = 7) attained 100% CR and long-term survival (71.4% DFS and 85.7% OS at 3 years). Thus, intensified DNR administration of 280 mg/m2 (40 mg/m2 per day for 7 days) in induction therapy for adult patients younger than 60 years of age might be optimal or at least comparable with the new anthracyclines such as idarubicin. In addition, autologous PBSCT in postremission therapy might improve DFS and OS, at least for patients in a favorable cytogenetic group, such as those with a t(8;21) abnormality.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. usuin@jikei.ac.jp
authors.forename: Noriko
authors.initials: N
authors.lastname: Usui
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Dobashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Asai
authors.forename: Shingo
authors.initials: S
authors.lastname: Yano
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yahagi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Kinuyo
authors.initials: K
authors.lastname: Kasama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okawa
authors.forename: Naohiro
authors.initials: N
authors.lastname: Sekiguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takei
authors.forename: Katsuki
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Yoji
authors.initials: Y
authors.lastname: Ogasawara
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ohtsubo
authors.forename: Ken
authors.initials: K
authors.lastname: Kaito
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kobayashi
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003630:Daunorubicin / Q000008:administration & dosage* / Q000633:toxicity; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality; D012074:Remission Induction / Q000379:methods; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003630:Daunorubicin