title: Primacy of resistance rather than toxicity in determining outcome of therapy for AML.
abstract: Less intense therapies are currently attracting much interest in the treatment of newly-diagnosed acute myeloid leukemia (AML). Although "less intense" often goes undefined, I understand it to mean a therapy that very likely causes less treatment-related mortality than does the standard remission induction regimen of 3 days of either daunorubicin or idarubicin and 7 days of ara-C, referred to as "3 + 7." The primary appeal of less intense therapy is the potential for less toxicity. However, in this article I will make the point that for most patients, including many in their 70s if not 80s, the fundamental obstacle to curing AML is lack of efficacy not excess toxicity.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Electronic address: eestey@uw.edu.
authors.forename: Elihu H
authors.initials: EH
authors.lastname: Estey
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D012074:Remission Induction; D012307:Risk Factors; D016896:Treatment Outcome
keywords: 3+7; Induction therapy; Older patients; Therapeutic resistance; Treatment-related mortality