title: Daunorubicin versus mitoxantrone versus idarubicin as induction and consolidation chemotherapy for adults with acute myeloid leukemia: the EORTC and GIMEMA Groups Study AML-10.
abstract: OBJECTIVE
  To compare the antitumor efficacy of three different anthracyclines in combination with cytarabine and etoposide in adult patients with newly diagnosed acute myeloid leukemia (AML).
  
  
  METHODS
  We randomly assigned 2,157 patients (age range, 15 to 60 years) to receive intensive induction-consolidation chemotherapy containing either daunorubicin, idarubicin, or mitoxantrone. After achieving complete remission (CR), patients were assigned to undergo either allogeneic or autologous stem-cell transplantation (SCT), depending on the availability of a sibling donor.
  
  
  RESULTS
  The overall CR rate (69%) was similar in the three groups. Autologous SCT was performed in 37% of cases in the daunorubicin arm versus only 29% and 31% in mitoxantrone and idarubicin, respectively (P < .001). However, the disease-free survival (DFS) and survival from CR were significantly shorter in the daunorubicin arm: the 5-year DFS was 29% versus 37% and 37% in mitoxantrone and idarubicin, respectively. The proportion of patients who underwent allogeneic SCT (22%) was equivalent in the three treatment groups, and the outcome was similar as well. The [corrected] 5-year overall survival rates were 31%, 34%, and 34%, [corrected] respectively.
  
  
  CONCLUSIONS
  In adult patients with AML who do not receive an allogeneic SCT, the use of mitoxantrone or idarubicin instead of daunorubicin enhances the long-term efficacy of chemotherapy.
authors.affiliation: Department of Cellular Biotechnologies and Hematology, SapienzaUniversity, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
authors.forename: Marco
authors.initials: M
authors.lastname: Vignetti
authors.forename: Stefan
authors.initials: S
authors.lastname: Suciu
authors.forename: Roberto
authors.initials: R
authors.lastname: Stasi
authors.forename: Maria-Concetta
authors.initials: MC
authors.lastname: Petti
authors.forename: Giovanna
authors.initials: G
authors.lastname: Meloni
authors.forename: Petra
authors.initials: P
authors.lastname: Muus
authors.forename: Filippo
authors.initials: F
authors.lastname: Marmont
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marie
authors.forename: Boris
authors.initials: B
authors.lastname: Labar
authors.forename: Xavier
authors.initials: X
authors.lastname: Thomas
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Raimondo
authors.forename: Roel
authors.initials: R
authors.lastname: Willemze
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Liso
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Liliana
authors.initials: L
authors.lastname: Baila
authors.forename: Paola
authors.initials: P
authors.lastname: Fazi
authors.forename: Robert
authors.initials: R
authors.lastname: Zittoun
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D012074:Remission Induction; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone; D015255:Idarubicin; D003630:Daunorubicin