title: Optimal dose and schedule of consolidation in AML: is there a standard?
abstract: Approximately 35%-40% of younger adults with acute myeloid leukemia (AML) can be cured using higher doses of cytosine arabinoside (ara-C) as post remission consolidation. Earlier studies focused on higher doses of 3 gms/m(2), but since then numerous studies evaluating differences in dose, schedule, number of courses, and the addition of other agents, suggest that an intermediate-dose of ara-C may offer the greatest benefit to most patients with less toxicity than with higher dose regimens. In retrospect, this was predictable by the cellular pharmacology of ara-C. Perhaps most importantly, the overall outcome has not changed in the past 2-3 decades, indicating that the limits of available chemotherapy have been defined for AML. This review examines studies that have established the various dosing options and considers whether there is a true standard for post remission therapy for patients with AML.
authors.affiliation: Division of Hematology/Oncology, Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, HWCRC-4th Floor, 4100 John R, Detroit, MI 48201, USA. Electronic address: schiffer@karmanos.org.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Schiffer
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D060830:Consolidation Chemotherapy / Q000379:methods* / Q000592:standards*; D003561:Cytarabine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D012074:Remission Induction
chemical_list: D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine
keywords: AML; acute myeloid leukemia; ara-C; cytarabine; high-dose; intermediate-dose