Therapeutic Effect and Prognostic Analysis of Induction Chemotherapy with Idarubicin/BH-AC in Acute Myelogenous Leukemia

Lee, Je Jung; Chung, Ik Joo; Yang, Duc Hwan; Cho, Sang Hee; Yang, Tae Young; Park, Hyeong Cheon; Park, Moo Rim; Kim, Hyeoung Joon

Abstract

BACKGROUND: We have analyzed the outcome and prognostic factors for 61 patients with acute myelogenous leukemia (AML) who were treated with idarubicin(IDA)/N 4-behenoyl- 1-beta-D-arabinofuranosylcytosine(BH-AC) regimen at Chonnam National University Hospital between April 1994 and December 1998.
METHODS
Fifty-six patients with newly diagnosed AML and 5 patients failed by IDA/ara- C were eligible to analysis. Remission induction chemotherapy consisted of IDA (12 mg/m2/day IV over 30 minutes on days 1~3) and BH-AC (age < or =40 years: 300 mg/m2/day IV over 4 hours on days 1~7; age >40 years: 200 mg/m2/day). After achievement of a complete remission (CR), four polychemotherapy cycles, allogeneic BMT or autologous PBSCT were given as consolidation.
RESULTS
Median age was 38 years (range, 17 to 65). Of 61 patients, 43 (70.5%) achi-eved CR and 6 (9.8%) died of early complications. The Kaplan-Meier estimated overall survival rate was 51.8+/-7.7%, 43.1+/-8.5% and 29.6+/-8.8% at 1 year, 2 year and 3 year respectively, and the disease free survival rate was 58.4+/-9.7%, 43.3+/-10.4% and 24.0+/-12.2 % at 1 year, 2 year and 3 year, respectively. Unfavorable prognostic variables for achieving CR were age >55 years (P =0.006), FAB subtypes (P=0.005) and poor risk cytogenetic abnormalities (P=0.021), and FAB subtypes for overall survival (P=0.0064).
CONCLUSION
IDA/BH-AC combination chemotherapy is an effective and well-tolerated regimen for induction treatment of AML.