Efficacy and Toxicity of Induction Therapy with Cladribine, Idarubicin, and Cytarabine (IAC) for Acute Myeloid Leukemia.
We report our single-center experience with cytarabine and idarubicin for induction therapy for acute myeloid leukemia (AML) with an additional 5 days of cladribine (IAC therapy). From July 2012 to September 2014, 38 patients completed a full course of IAC induction. Median patient age was 61 years, 61% of patients were ≥60 years old, and 71% were male. The complete remission (CR) rate was 63% following a single induction course, three patients (8%) required a second induction course to achieve CR, for an overall response rate of 71%. The median duration of severe neutropenia was 30.5 days. Thirty-two percent of patients developed mucositis, 76% experienced diarrhea, and 61% developed a rash. Incidence of CR following IAC induction therapy for AML was comparable to historical data, but with frequent diarrhea, rash, and fungal infections. This study found IAC efficacy and toxicity was similar irrespective of age.
SSM Saint Louis University Hospital, Saint Louis, MO, U.S.A.
Susan K
SK
Woelich
SSM Saint Louis University Hospital, Saint Louis, MO, U.S.A.
James T
JT
Braun
Saint Louis University School of Medicine, Saint Louis, MO, U.S.A.
Martin W
MW
Schoen
Saint Louis University School of Medicine, Saint Louis, MO, U.S.A.
Reshma
R
Ramlal
Saint Louis University School of Medicine, Saint Louis, MO, U.S.A.
Carl E
CE
Freter
Saint Louis University School of Medicine, Saint Louis, MO, U.S.A.
Paul J
PJ
Petruska
Saint Louis University School of Medicine, Saint Louis, MO, U.S.A. jlionber@slu.edu.
Jack M
JM
Lionberger
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017338:Cladribine / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003967:Diarrhea / Q000139:chemically induced; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000009:adverse effects; D060828:Induction Chemotherapy; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000139:chemically induced; D009503:Neutropenia / Q000139:chemically induced; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D003561:Cytarabine; D017338:Cladribine; D015255:Idarubicin
AML; Acute myeloid leukemia; adverse events; cladribine; induction chemotherapy; toxicity