title: Important milestones in acute leukemia in 2013.
abstract: This year marked the occurrence of several important milestones in the treatment of acute leukemias. First, the standard 7 + 3 protocol for acute myeloid leukemia (AML) was developed 40 years ago, and with some adaptations, has stood the test of time. Second, the 1 millionth hematopoietic cell transplant was recorded this year. Stem cell transplant, the first reported by Dr E. Donnall Thomas in 1957, had been considered a rare procedure until about a decade ago. Today, it has become a proven and often life-saving therapy for patients with acute leukemia. Advances in the treatment of patients with AML continue to take place, many of which relate to an increased understanding of the clinical heterogeneity of known subtypes. Forty years ago, the regimen that has come to be known as 7+3 for acute myeloid leukemia (AML) was born [1,2]. Cytosine arabinoside, or arabinosylcytosine as it was then called, was given as a continuous intravenous infusion of 100 mg/m(2) for 7 days, and the anthracycline, daunorubicin, was administered at 45 mg/m(2) intravenously for 3 days. Sixteen patients were originally treated on this protocol, and 5 of 8 previously untreated and 2 of 8 previously treated patients achieved a complete response (CR). This regimen has withstood the test of time. Attempts to add or substitute other agents have not yielded superior results. The only major contemporary change is that a higher dose of daunorubicin is safe and has become the standard of care [3].
authors.affiliation: Technion, Israel Institute of Technology, 31096 Haifa, Israel; Rambam Health Care Campus, Department of Hematology, Haifa, Israel; Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Shaare Zedek Medical Center, Department of Hematology, Jerusalem 91031, Israel. Electronic address: rowe@jimmy.harvard.edu.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Rowe
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000266:history / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000266:history / Q000706:statistics & numerical data*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009154:Mutation; D009363:Neoplasm Proteins / Q000235:genetics*; D012074:Remission Induction; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins; D003561:Cytarabine; D003630:Daunorubicin
keywords: 7+3; AML; acute leukemia forum; acute myeloid leukemia; hematopoietic cell transplant