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A randomized trial of high-dose versus conventional-dose cytarabine in consolidation chemotherapy for adult de nova acute myeloid leukemia in first remission after induction therapy containing high-dose cytarabine

Citation

Bradstock, KF and Mathews, JP and Lowenthal, RM and Baxter, H and Catalano, J and Brighton, T and Gill, D and Elliadis, P and Joshua, D and Cannell, P and Schwarer, AP and Durrant, S and Gillett, A and Koutts, J and Taylor, K and Bashford, J and Arthur, C and Enno, A and Dunlop, L and Szer, J and Leahy, M and Juneja, S and Young, GAR, A randomized trial of high-dose versus conventional-dose cytarabine in consolidation chemotherapy for adult de nova acute myeloid leukemia in first remission after induction therapy containing high-dose cytarabine, Blood, 105, (2) pp. 481-488. ISSN 0006-4971 (2005) [Refereed Article]

DOI: doi:10.1182/blood-2004-01-0326

Abstract

The value of administering sequential courses of chemotherapy containing high-dose cytarabine in both induction and consolidation therapy for acute myeloid leukemia (AML) has not been assessed in a prospective randomized trial. Two hundred ninety-two AML patients aged 15 to 60 years were enrolled in the Australasian Leukaemia and Lymphoma Group (ALLG) AML trial number 7 (M7) protocol to evaluate this question. All received induction therapy with the ICE protocol (idarubicin 9 mg/m 2 × 3; cytarabine 3 g/m 2 twice a day on days 1, 3, 5, 7; etoposide 75 mg/m 2 × 7). Complete remission was achieved in 234 (80%) patients. Two hundred two patients in remission were then randomized to either a further identical cycle of ICE or 2 attenuated courses (cytarabine 100 mg/m 2 daily × 5, idarubicin × 2, etoposide × 5 [IcE]). ICE consolidation therapy was more toxic than IcE, however, the treatment-related death rate was not significantly different. There was no difference between the 2 consolidation arms for relapse-free survival at 3 years (49% for ICE vs 46% for IcE; P = .66), survival following randomization (61% vs 62%; P = .91), or the cumulative incidence of relapse (43% vs 51%; P = .31), and there was no difference within cytogenetic risk groups. Intensive induction chemotherapy incorporating high-dose cytarabine results in high complete remission rates, but further intensive consolidation treatment does not appear to confer additional benefit. © 2005 by The American Society of Hematology.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Oncology and Carcinogenesis
Research Field:Oncology and Carcinogenesis not elsewhere classified
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cancer and Related Disorders
Author:Lowenthal, RM (Professor Ray Lowenthal)
ID Code:36157
Year Published:2005
Web of Science® Times Cited:62
Deposited By:Medicine (Discipline)
Deposited On:2005-08-01
Last Modified:2012-03-01
Downloads:0

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