Cytarabine Plus Daunorubicin or Idarubicin as Induction Chemotherapy for the Patients with De novo Acute Myelogenous Leukemia

Ahn, Jin Hee; Lee, Je Hwan; Lee, Kyoo Hyung; Bahng, Haeseoung; Lee, Jung Hee; Lee, Jung Shin; Kim, Sang Hee; Kim, Woo Kun

Abstract

BACKGROUND: The combination of cytarabine plus anthracycline has been considered standard chemotherapy for acute myelogenous leukemia (AML). We retrospectively analyzed the treatment results of the patients with de novo AML who received cytarabine plus daunorubicin or idarubicin as induction chemotherapy.
METHODS
From 1989 to 1998, 149 patients with AML were included. For induction chemotherapy, the patients received cytarabine 100~ 200 mg/m2/day given by continuous 7-day in fusion plus either daunorubicin 40~45 mg/m2/ day (A+D) or idarubicin 12 mg/m2/day (A+I) administered for the first 3 days of treatment. We reviewed clinical records of the patients and analyzed the treatment results such as complete remission (CR) rate, disease free survival (DFS), and overall survival (OS).
RESULTS
The CR rates were 67.1% (100 of 149); 69.3% (70 of 101) in A+D group and 62.5 % (30 of 48) in A+I group (P=0.409). The frequent reason of induction failure was resistant disease in A+D group (54.8%) and early death in A+I group (66.7%). The median DFS was 344 days; 344 days in A+D group and 314 days in A+I group. The median OS was 379 days; 389 days in A+D group and 379 days in A+I group. Age < or =60 years and allogeneic BMT as postremission therapy were independent favorable factors both for DFS and OS. AML M3 was favorable factor only for DFS.
CONCLUSION
The combination of cytarabine plus daunorubicin or idarubicin was effective for the treatment of AML. We can not find significant difference in CR rate, disease free survival and overall survival between A+D and A+I group.