Standard induction chemotherapy followed by attenuated consolidation in elderly patients with acute myeloid leukemia.
The benefits of intensive post-remission chemotherapy have not been verified in elderly patients with acute myeloid leukemia (AML). To reduce fatal complications caused by intensive post-remission therapy, we performed a prospective phase II multicenter trial of standard induction chemotherapy ('7+3' of cytarabine plus daunorubicin), followed by two cycles of attenuated consolidation therapy ('5+1' of cytarabine plus daunorubicin) for elderly patients with AML, excluding those with M3. Of the 41 patients enrolled in the study, 24 (58.5%) attained CR. Of these 24, 17 (70.8%) completed both planned cycles of consolidation therapy. After a median follow-up of 566 days (range, 63-1190 days) among surviving patients, 15 relapsed, with an actuarial 3-year disease-free survival rate of 22.5%. There were no fatal complications during consolidation therapy. Actuarial 3-year overall survival was 17.0%. These findings suggest that, when compared with previous findings using more intensive consolidation therapy, attenuated consolidation therapy does not compromise outcomes in elderly AML patients.
Department of Internal Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, South Korea. jhlee3@amc.seoul.kr
Je-Hwan
JH
Lee
Seong-Jun
SJ
Choi
Jung-Hee
JH
Lee
Jae-Hoo
JH
Park
Hawk
H
Kim
Young-Don
YD
Joo
Won Sik
WS
Lee
Dae Young
DY
Zang
Hyo Jung
HJ
Kim
Kyoo-Hyung
KH
Lee
D000208:Acute Disease; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping / Q000379:methods; D004915:Leukemia, Erythroblastic, Acute / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D007947:Leukemia, Megakaryoblastic, Acute / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D007948:Leukemia, Monocytic, Acute / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D015479:Leukemia, Myelomonocytic, Acute / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome