Daunorubicin dose in AML

This study, from 2009, examined the effectiveness of increasing the dose of daunorubicin (Cerubidine) in acute myeloid leukemia (AML). This study concluded that a higher dose improved remission rates (no sign of disease) and 2-year survival rates.

The standard induction therapy (treatment to induce remission) for AML is chemotherapy. Three days of an anthracycline (such as daunorubicin) combined with 7 days of cytarabine (Cytosar-U) is widely used. This leads to complete remission (CR) in 50-75% of patients. It is possible that increasing the anthracycline dose may improve remission and survival rates.

This study compared the effectiveness of two doses of daunorubicin. 582 patients were randomly assigned to treatment with 45 mg/m2 (standard dose) or 90 mg/m2 (high dose). Patients were followed for an average of 25 months.

57.3% of patients in the standard dose group achieved CR. This was compared to 70.6% of the high dose group. Of those who achieved CR in the standard dose group, 72% did so in one treatment cycle. 88.3% of the high dose group achieved CR in one cycle.

Average overall survival (time from treatment until death from any cause) was 23.7 months in the high-dose group and 15.7 months in the standard dose group.

Rates of negative side effects were similar between the groups.

Patients over the age of 50 did not see a benefit of the higher dose, but experienced similar rates of severe side effects.

This study concluded that increased doses of daunorubicin improved remission and survival rates in patients with AML.

This was a study published in 2009. More recent studies have noted that 60 mg/m2 of daunorubicin are also effective.