Benefit of high-dose idarubicin as induction therapy in acute myeloid leukemia: a prospective phase 2 study

Ann Hematol. 2022 Apr;101(4):831-836. doi: 10.1007/s00277-022-04764-4. Epub 2022 Jan 17.

Abstract

Idarubicin 12 mg/m2 has been recommended as a standard induction therapy for acute myeloid leukemia (AML). It is unknown whether a higher dose of idarubicin can improve the remission rate. This phase 2 prospective single-arm study enrolled 45 adults with newly diagnosed AML between September 2019 and May 2021 (NCT 04,069,208). Induction therapy included administration of idarubicin 14 mg/m2 for 3 days and cytarabine 100 mg/m2 every 12 h subcutaneously for 7 days. The primary endpoint was the composite complete response rate (complete response (CR) plus complete response with incomplete blood count recovery (CRi)). The median age was 45 years (range 14-60 years). Forty (88.9%) patients had CR or CRi, including 39 patients with CR and 1 patient with CRi after one course of induction therapy. The median times to recovery of absolute neutrophil and platelet counts were 21 days. Only 1 patient died of intracranial hemorrhage during induction therapy. After a median follow-up of 14 months (range 3.5-24 months), the estimated 18-month overall survival and disease-free survival (DFS) were 66.9% and 57.5%, respectively. In conclusion, idarubicin 14 mg/m2 plus cytarabine was a safe and efficient intensive regimen for younger and fit patients with newly diagnosed AML.

Keywords: Acute myeloid leukemia; High-dose idarubicin; Induction.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cytarabine
  • Humans
  • Idarubicin*
  • Induction Chemotherapy
  • Leukemia, Myeloid, Acute* / drug therapy
  • Middle Aged
  • Prospective Studies
  • Remission Induction
  • Young Adult

Substances

  • Cytarabine
  • Idarubicin