Remission induction therapy for adults with acute myelogenous leukemia: towards the ICE age?

The primary goal of acute myeloid leukemia chemotherapy is to obtain a complete remission. In adults with de novo disease, response rates reach between sixty and seventy per cent with classical '3 + 7' or DAT schemes. Curative postinduction treatments are now available for responsive patients, which makes it mandatory to look for more effective modalities of induction therapy. Experience gathered in recent years shows that idarubicin, cytosine arabinoside, and etoposide together might contribute to the modeling of an improved remission induction regimen: ICE. Because ICE and similar programs are being used with increasing frequency worldwide, we decided to review critically the underlying issues and the evidence supporting this change.