title: Comparison of consolidation strategies in acute myeloid leukemia: high-dose cytarabine alone versus intermediate-dose cytarabine combined with anthracyclines.
abstract: We compared the efficacy of high-dose cytarabine alone to that of intermediate-dose cytarabine combined with anthracyclines as consolidation therapy. Patients enrolled in the Korea University acute myeloid leukemia (AML) registry received remission induction chemotherapy with the same standard induction regimen (idarubicin and cytarabine 3 + 7). Postremission therapy was performed for three or four cycles according to one of the following regimens: high-dose cytarabine (3 g/m(2)) or combination of intermediate-dose cytarabine (1 g/m(2)) with anthracyclines (idarubicin or mitoxantrone). Among the 443 AML patients enrolled in the registry, 145 patients received consolidation chemotherapy. The median overall survival (OS) and relapse-free survival (RFS) in the high-dose cytarabine group were significantly longer than those in the anthracycline combination group (OS, not reached vs. 16.6 months, p = 0.045; RFS, 38.6 months vs. 11.0 months, p = 0.011). The median duration of neutropenia was longer in the anthracycline combination group than in the high-dose cytarabine group (8 vs. 10 days, p = 0.001). This study suggests that high-dose cytarabine consolidation may produce superior outcomes than combination treatment with intermediate-dose cytarabine and anthracyclines and that the addition of anthracyclines during AML consolidation has limited value as compared to cytarabine intensification.
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Korea University School of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 136-705, Republic of Korea.
authors.forename: Dae Sik
authors.initials: DS
authors.lastname: Kim
authors.forename: Ka-Won
authors.initials: KW
authors.lastname: Kang
authors.forename: Se Ryeon
authors.initials: SR
authors.lastname: Lee
authors.forename: Yong
authors.initials: Y
authors.lastname: Park
authors.forename: Hwa Jung
authors.initials: HJ
authors.lastname: Sung
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Choi
authors.forename: Byung Soo
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D060830:Consolidation Chemotherapy / Q000379:methods*; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate
chemical_list: D018943:Anthracyclines; D003561:Cytarabine