The effect of decreased-dose idarubicin for elderly patients with acute myeloid leukemia.

We evaluated whether reduced-dose chemotherapy with 2 days of idarubicin (12 mg/m(2)) and 5 days of cytarabine (100 mg/m(2)) (2 + 5) is effective for patients aged 65-74 by retrospectively comparing the results with those aged 55-64 treated with 3 + 7. In 1999-2009, we treated 20 patients aged 65-74 with 2 + 5, and 23 patients aged 55-64 with 3 + 7. The complete remission rates by the first induction were 50.0 and 69.6% for older and younger groups (P = 0.203). Two-year overall survival rates were 55.9 and 32.3% for older and younger groups; 2-year rates of relapse-free survival for all these patients were 15.7 and 36.5%. The differences in overall and relapse-free survival were statistically insignificant (P = 0.726 and 0.413, respectively). The treatment results of 2 + 5 for the older group were not significantly worse compared with those of 3 + 7 for the younger. Therefore, elderly patients who do not tolerate 3 + 7 should still benefit from 2 + 5.

[1]  J. Ouyang,et al.  Meta-Analysis of Randomised Clinical Trials Comparing Idarubicin + Cytarabine with Daunorubicin + Cytarabine as the Induction Chemotherapy in Patients with Newly Diagnosed Acute Myeloid Leukaemia , 2013, PloS one.

[2]  Y. Yamaguchi,et al.  Administration schedule of daunorubicin for elderly patients with acute myelogenous leukemia: a single-institute experience. , 2011, Japanese journal of clinical oncology.

[3]  T. Naoe,et al.  Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia: the JALSG AML201 Study. , 2011, Blood.

[4]  H. Kantarjian,et al.  Intensive chemotherapy does not benefit most older patients (age 70 years or older) with acute myeloid leukemia. , 2010, Blood.

[5]  J. Bourhis,et al.  Randomized study of intensified anthracycline doses for induction and recombinant interleukin-2 for maintenance in patients with acute myeloid leukemia age 50 to 70 years: results of the ALFA-9801 study. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  H. Döhner,et al.  High-dose daunorubicin in older patients with acute myeloid leukemia. , 2009, The New England journal of medicine.

[7]  C. Craddock,et al.  Guidelines on the management of acute myeloid leukaemia in adults , 2006, British journal of haematology.

[8]  D. Neuberg,et al.  A phase 3 study of three induction regimens and of priming with GM-CSF in older adults with acute myeloid leukemia: a trial by the Eastern Cooperative Oncology Group. , 2004, Blood.

[9]  R. Clark,et al.  Attempts to improve treatment outcomes in acute myeloid leukemia (AML) in older patients: the results of the United Kingdom Medical Research Council AML11 trial. , 2001, Blood.

[10]  K Wheatley,et al.  The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties. , 1998, Blood.

[11]  R. Zittoun,et al.  Acute myelogenous leukaemia in the elderly: retrospective study of 235 consecutive patients , 1994, British journal of haematology.

[12]  A. Bartolucci,et al.  A phase III trial comparing idarubicin and daunorubicin in combination with cytarabine in acute myelogenous leukemia: a Southeastern Cancer Study Group Study. , 1992, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  Janice Gabrilove,et al.  Results of a randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed acute myelogenous leukemia , 1991 .

[14]  M. Gordon.  Daunorubicin Versus Mitoxantrone Versus Idarubicin As Induction and Consolidation Chemotherapy for Adults With Acute Myeloid Leukemia: The EORTC and GIMEMA Groups Study AML-10 , 2010 .

[15]  M. Patnaik,et al.  Anthracycline dose intensification in acute myeloid leukemia. , 2009, The New England journal of medicine.

[16]  P. Ritch,et al.  Cytarabine plus idarubicin or daunorubicin as induction and consolidation therapy for previously untreated adult patients with acute myeloid leukemia. , 1992, Blood.

[17]  T Maekawa,et al.  Criteria for diagnosis of DIC based on the analysis of clinical and laboratory findings in 345 DIC patients collected by the Research Committee on DIC in Japan. , 1983, Bibliotheca haematologica.