Standard induction chemotherapy followed by attenuated consolidation in elderly patients with acute myeloid leukemia

Ann Hematol. 2006 Jun;85(6):357-65. doi: 10.1007/s00277-006-0110-8. Epub 2006 Mar 31.

Abstract

The benefits of intensive post-remission chemotherapy have not been verified in elderly patients with acute myeloid leukemia (AML). To reduce fatal complications caused by intensive post-remission therapy, we performed a prospective phase II multicenter trial of standard induction chemotherapy ('7+3' of cytarabine plus daunorubicin), followed by two cycles of attenuated consolidation therapy ('5+1' of cytarabine plus daunorubicin) for elderly patients with AML, excluding those with M3. Of the 41 patients enrolled in the study, 24 (58.5%) attained CR. Of these 24, 17 (70.8%) completed both planned cycles of consolidation therapy. After a median follow-up of 566 days (range, 63-1190 days) among surviving patients, 15 relapsed, with an actuarial 3-year disease-free survival rate of 22.5%. There were no fatal complications during consolidation therapy. Actuarial 3-year overall survival was 17.0%. These findings suggest that, when compared with previous findings using more intensive consolidation therapy, attenuated consolidation therapy does not compromise outcomes in elderly AML patients.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Disease-Free Survival
  • Female
  • Flow Cytometry
  • Humans
  • Immunophenotyping / methods
  • Leukemia, Erythroblastic, Acute / drug therapy
  • Leukemia, Erythroblastic, Acute / immunology
  • Leukemia, Erythroblastic, Acute / pathology
  • Leukemia, Megakaryoblastic, Acute / drug therapy
  • Leukemia, Megakaryoblastic, Acute / immunology
  • Leukemia, Megakaryoblastic, Acute / pathology
  • Leukemia, Monocytic, Acute / drug therapy
  • Leukemia, Monocytic, Acute / immunology
  • Leukemia, Monocytic, Acute / pathology
  • Leukemia, Myeloid / drug therapy*
  • Leukemia, Myeloid / immunology
  • Leukemia, Myeloid / pathology
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / immunology
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myelomonocytic, Acute / drug therapy
  • Leukemia, Myelomonocytic, Acute / immunology
  • Leukemia, Myelomonocytic, Acute / pathology
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Treatment Outcome