title: [Comparison of 10 mg/m² or 8 mg/m² idarubicin plus cytarabine regimen as induction chemotherapy for adult patients with newly diagnosed acute myeloid leukemia].
abstract: OBJECTIVE
  To compare the efficacy and toxicity of 10 mg/m² or 8 mg/m² idarubicin (Ida) combined with cytarabine (IA"3+7"regimen) as induction chemotherapy for adult patients with newly diagnosed acute myeloid leukemia (AML).
  
  
  METHODS
  From June 2004 to October 2013, 335 adult AML (non acute promyelocytic leukemia) patients receiving the IA regimen as induction chemotherapy were enrolled, including 198 cases with 10 mg/m² Ida and 137 cases with 8 mg/m² Ida for 3 days. We compared the hematologic response, hematologic side effects and prognosis between the two regimens.
  
  
  RESULTS
  Except for 4 early deaths, the complete remission (CR) rate after the first cycle of induction chemotherapy was 72.5%, 10.0% partial remission (PR) and 82.5% overall remission (OR) rate. The CR and OR rates were higher in the 10 mg/m² Ida group than the 8 mg/m² Ida group (CR: 78.9% vs 63.5%, P=0.003; OR: 88.2% vs 75.4%, P=0.007). Multivariate analysis showed that female, HGB≥100 g/L, FLT3-ITD mutation negative and 10 mg/m² Ida were favorable factors for CR. All patients presented cytopenias of grade Ⅳ. There was no differences on the recovery time of ANC≥0.5×10⁹/L and PLT≥20×10⁹/L after induction chemotherapy. Within a median follow-up of 14 (1-118) months, 98 (29.3%) patients relapsed, 92 (27.5%) died. The disease-free survival (DFS) and overall survival (OS) at 3 years were 53.2% and 58.9%, respectively. DFS and OS at 3-year were 34.2% and 37.4% in the chemotherapy cohort, 74.5% and 81.2% in the transplant cohort. 10 mg/m² Ida was an independent favorite factor for DFS (P=0.040) and OS (P=0.007).
  
  
  CONCLUSIONS
  As compared to 8 mg/m², 10 mg/m² Ida significantly improved the CR, with the same extent of hematological side effects, and was an independent favorite factor for DFS and OS.
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Yuanyuan
authors: Y
authors: Zhang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Shenmiao
authors: S
authors: Yang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Jing
authors: J
authors: Wang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Honghu
authors: H
authors: Zhu
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Li
authors: L
authors: Bao
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Jinsong
authors: J
authors: Jia
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Ting
authors: T
authors: Zhao
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Hao
authors: H
authors: Jiang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Jin
authors: J
authors: Lu
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Bin
authors: B
authors: Jiang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Xiaojun
authors: X
authors: Huang
authors: Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.
authors: Qian
authors: Q
authors: Jiang
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols; D003561:Cytarabine; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015255:Idarubicin; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute; D011379:Prognosis; D012074:Remission Induction
chemical_list: D003561:Cytarabine; D015255:Idarubicin