In a nutshell
This study aimed to compare levels of early complete remission in patients with acute myeloid leukemia (AML) treated with standard or sequential high-dose chemotherapy.
This study concluded that sequential high-dose chemotherapy led to early complete remission in these patients.
Some background
Sequential high-dose chemotherapy (SHD) uses cytarabine (Cytosar-U) and then idarubicin (Idamycin). Both drugs are chemotherapy used for AML. Standard-intensity idarubicin–cytarabine–etoposide (ICE) chemotherapy uses idarubicin, cytarabine and etoposide (Etopophos) is a chemotherapy that can be used to treat various types of cancers. Complete remission (CR) is when there are no signs of the cancer left.
It was not known if SHD would increase early CR in patients with AML when compared to ICE.
Methods & findings
This study involved 572 patients with AML. 286 patients received ICE and 286 patients received SHD. Patients who responded to the initial treatments received further treatments. Standard-risk patients received autograft (their own cells) or repetitive blood stem cell-supported high dose courses. High-risk patients received allotransplantation (cells from a donor).
The ICE group had a CR rate of 80.8% after 2 treatment courses compared to 83.6% for the SHD group. The ICE group had a CR rate of 69.2% after 1 treatment course compared to 81.5% in the SHD group.
The SHD group had a 5-year overall survival rate of 49% compared to 39% for the ICE group. Relapse-free survival (survival without the disease coming back) was 48% for the SHD group compared to 36% for the ICE group.
The bottom line
This study concluded that SHD achieved rapid CR in patients with AML and improved survival outcomes.
The fine print
This study only included patients over the age of 60. Treatment was not delivered the same in all patients. This might have influenced results.
What’s next?
Published By :
Blood advances
Date :
Apr 09, 2019
