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.
Lee
Je-Hwan
JH
Department of Internal Medicine, Asan Medical Center, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, South Korea. jhlee3@amc.seoul.kr
Choi
Seong-Jun
SJ
Lee
Jung-Hee
JH
Park
Jae-Hoo
JH
Kim
Hawk
H
Joo
Young-Don
YD
Lee
Won Sik
WS
Zang
Dae Young
DY
Kim
Hyo Jung
HJ
Lee
Kyoo-Hyung
KH
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