PURPOSE: To compare the antitumor efficacy of three different anthracyclines in combination with cytarabine and etoposide in adult patients with newly diagnosed acute myeloid leukemia (AML). PATIENTS AND METHODS: We randomly assigned 2,157 patients (age range, 15 to 60 years) to receiveintensive induction-consolidation chemotherapy containing either daunorubicin, idarubicin, or mitoxantrone. After achieving complete remission (CR), patients were assigned to undergo either allogeneic or autologous stem-cell transplantation (SCT), depending on the availability of a sibling donor. RESULTS: The overall CR rate (69%) was similar in the three groups. Autologous SCT was performed in 37% of cases in the daunorubicin arm versus only 29% and 31% in mitoxantrone and idarubicin, respectively (P < .001). However, the disease-free survival (DFS) and survival from CR were significantly shorter in the daunorubicin arm: the 5-year DFS was 29% versus 37% and 37% in mitoxantrone and idarubicin, respectively. The proportion of patients who underwent allogeneic SCT (22%) was equivalent in the three treatment groups, and the outcome was similar as well. The [corrected] 5-yearoverall survival rates were 31%, 34%, and 34%, [corrected] respectively. CONCLUSION: In adult patients with AML who do not receive an allogeneic SCT, the use of mitoxantrone or idarubicin instead of daunorubicin enhances the long-term efficacy of chemotherapy.
RCT Entities:
PURPOSE: To compare the antitumor efficacy of three different anthracyclines in combination with cytarabine and etoposide in adult patients with newly diagnosed acute myeloid leukemia (AML). PATIENTS AND METHODS: We randomly assigned 2,157 patients (age range, 15 to 60 years) to receive intensive induction-consolidation chemotherapy containing either daunorubicin, idarubicin, or mitoxantrone. After achieving complete remission (CR), patients were assigned to undergo either allogeneic or autologous stem-cell transplantation (SCT), depending on the availability of a sibling donor. RESULTS: The overall CR rate (69%) was similar in the three groups. Autologous SCT was performed in 37% of cases in the daunorubicin arm versus only 29% and 31% in mitoxantrone and idarubicin, respectively (P < .001). However, the disease-free survival (DFS) and survival from CR were significantly shorter in the daunorubicin arm: the 5-year DFS was 29% versus 37% and 37% in mitoxantrone and idarubicin, respectively. The proportion of patients who underwent allogeneic SCT (22%) was equivalent in the three treatment groups, and the outcome was similar as well. The [corrected] 5-year overall survival rates were 31%, 34%, and 34%, [corrected] respectively. CONCLUSION: In adult patients with AML who do not receive an allogeneic SCT, the use of mitoxantrone or idarubicin instead of daunorubicin enhances the long-term efficacy of chemotherapy.
Authors: J M Bennett; D Catovsky; M T Daniel; G Flandrin; D A Galton; H R Gralnick; C Sultan Journal: Ann Intern Med Date: 1985-10 Impact factor: 25.391
Authors: J F Bishop; R M Lowenthal; D Joshua; J P Matthews; D Todd; R Cobcroft; M G Whiteside; H Kronenberg; D Ma; A Dodds Journal: Blood Date: 1990-01-01 Impact factor: 22.113
Authors: Z Arlin; D C Case; J Moore; P Wiernik; E Feldman; S Saletan; P Desai; L Sia; K Cartwright Journal: Leukemia Date: 1990-03 Impact factor: 11.528
Authors: Jacob M Rowe; Donna Neuberg; William Friedenberg; John M Bennett; Elisabeth Paietta; Adel Z Makary; Jane L Liesveld; Camille N Abboud; Gordon Dewald; F Ann Hayes; Martin S Tallman; Peter H Wiernik Journal: Blood Date: 2003-09-25 Impact factor: 22.113
Authors: J Yates; O Glidewell; P Wiernik; M R Cooper; D Steinberg; H Dosik; R Levy; C Hoagland; P Henry; A Gottlieb; C Cornell; J Berenberg; J L Hutchison; P Raich; N Nissen; R R Ellison; R Frelick; G W James; G Falkson; R T Silver; F Haurani; M Green; E Henderson; L Leone; J F Holland Journal: Blood Date: 1982-08 Impact factor: 22.113
Authors: S Keating; S Suciu; T de Witte; R Zittoun; F Mandelli; A Belhabri; S Amadori; W Fibbe; E Gallo; G Fillet; B Varet; G Meloni; A Hagemeijer; P Fazi; G Solbu; R Willemze Journal: Leukemia Date: 2003-01 Impact factor: 11.528
Authors: Sunil Adige; Rena G Lapidus; Brandon A Carter-Cooper; Alison Duffy; Ciera Patzke; Jennie Y Law; Maria R Baer; Nicholas P Ambulos; Ying Zou; Søren M Bentzen; Ashkan Emadi Journal: Cancer Chemother Pharmacol Date: 2019-04-09 Impact factor: 3.333
Authors: C Récher; M C Béné; B Lioure; A Pigneux; N Vey; J Delaunay; I Luquet; M Hunault; D Guyotat; D Bouscary; N Fegueux; E Jourdan; S Lissandre; M Escoffre-Barbe; C Bonmati; E Randriamalala; R Guièze; M Ojeda-Uribe; F Dreyfus; J L Harousseau; J Y Cahn; N Ifrah; P Guardiola Journal: Leukemia Date: 2013-10-09 Impact factor: 11.528
Authors: Blake S Moses; Samantha McCullough; Jennifer M Fox; Bryan T Mott; Søren M Bentzen; MinJung Kim; Jeffrey W Tyner; Rena G Lapidus; Ashkan Emadi; Michelle A Rudek; Tami J Kingsbury; Curt I Civin Journal: Blood Adv Date: 2021-02-09