Buechner, Thomas and Berdel, Wolfgang E. and Schoch, Claudia and Haferlach, Torsten and Serve, Hubert L. and Kienast, Joachim and Schnittger, Susanne and Kern, Wolfgang and Tchinda, Joelle and Reichle, Albrecht and Lengfelder, Eva and Staib, Peter and Ludwig, Wolf-Dieter and Aul, Carlo and Eimermacher, Hartmut and Balleisen, Leopold and Sauerland, Maria Cristina and Heinecke, Achim and Woermann, Bernhard J. and Hiddemann, Wolfgang (2006) Double induction containing either two courses or one course of high-dose cytarabine plus mitoxantrone and postremission therapy by either autologous stem-cell transplantation or by prolonged maintenance for acute myeloid leukemia. JOURNAL OF CLINICAL ONCOLOGY, 24 (16). pp. 2480-2489. ISSN 0732-183X,
Full text not available from this repository. (Request a copy)Abstract
Purpose Intensification by high-dose cytarabine in postremission or induction therapy and prolonged maintenance are established strategies to improve the outcome in patients with acute myeloid leukemia (AML). Whether additional intensification can add to this effect has not yet been determined. Patients and Methods A total of 1,770 patients (age 16 to 85 years) with de novo or secondary AML or high-risk myelodysplastic syndrome (MDS) were randomly assigned upfront for induction therapy containing one course with standard dose and one course with high-dose cytarabine, or two courses with high-dose cytarabine, and in the same step received postremission prolonged maintenance or busulfan/cyclophosphamide chemotherapy with autologous stem-cell transplantation. Results The complete remission rate in patients younger than 60 and >= 60 years of age was 70% and 53%, respectively. The overall survival at 3 years in the two age groups was 42% and 19%, the relapse-free survival was 40% and 19%, and the ongoing remission duration was 48% and 22%, respectively. There were no significant differences in these results between the two randomized induction arms or between the two postremission therapy arms. There was no significant difference in any prognostic subgroup according to secondary AML/MDS, cytogenetics, WBC, lactate dehydrogenase, and early blast clearance. Conclusion The regimen of one course with standard-dose cytarabine and one course with high-dose cytarabine for induction, and prolonged maintenance for postremission chemotherapy in patients with AML is not improved by additional escalation in cytotoxic treatment.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | BONE-MARROW-TRANSPLANTATION; AML-COOPERATIVE-GROUP; WORLD-HEALTH-ORGANIZATION; COLONY-STIMULATING FACTOR; INTENSIVE CHEMOTHERAPY; COMPLETE REMISSION; CYTOSINE-ARABINOSIDE; RANDOMIZED-TRIAL; 1ST REMISSION; CLASSIFICATION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Feb 2021 09:10 |
| Last Modified: | 15 Feb 2021 09:10 |
| URI: | https://pred.uni-regensburg.de/id/eprint/34499 |
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