High-dose versus standard-dose daunorubicin in induction therapy for young patients with de novo acute myeloid leukaemia: a meta-analysis of randomised trials.
OBJECTIVE
To compare the efficacy and safety of high-dose versus standard-dose daunorubicin for young patients with de novo acute myeloid leukaemia (AML) using meta-analysis.


METHODS
Two trials were taken from 2,481 full-text articles. Heterogeneity was assessed using the I(2) index. Quality assessment was performed with the Cochrane Collaboration's risk-of-bias tool.


RESULTS
The analysis showed that high-dose daunorubicin induction therapy was associated with higher complete remission (CR) rate (n = 965; RR = 1.80; 95% CI = 1.36-2.38; p < 0.0001; I(2 )= 0%) and improved overall survival (n = 1040; HR = 0.74; 95% CI = 0.63-0.87; p = 0.0003; I(2 )= 0%) compared with standard-dose daunorubicin. However, there was no significant interaction between treatment efficacy and prognostic category based on cytogenetics (favourable, intermediate and unfavourable) (p = 0.44, I(2 )= 0%).


CONCLUSIONS
High-dose daunorubicin therapy could increase CR rate and improve long-term outcome for young patients with de novo AML. However, further study is needed to identify those who can benefit from high-dose daunorubicin.
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Long
L
Su
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Xiaoqing
X
Zhu
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Sujun
S
Gao
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Wei
W
Li
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Xiaoliang
X
Liu
a Cancer Center, the First Hospital , Jilin University , Changchun , China.
Yehui
Y
Tan
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D003630:Daunorubicin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D003630:Daunorubicin
Acute myeloid leukaemia; Complete remission rate; Daunorubicin; High-dose daunorubicin; Induction therapy; Meta-analysis; Standard-dose daunorubicin