Modified intermediate-dose cytarabine combined with daunorubicin induction and re-induction protocol use in patients with acute myeloid leukemia

Abstract

Background: A prospective study was conducted to investigate the response rate of patients newly diagnosed with acute myeloid leukemia (AML) to modified intermediate-dose cytarabine with daunorubicin. Methods: A total of 45 patients received cytarabine at a modified intermediate-dose (115 mg/m2) given by continuous intravenous infusion for 12 hours twice daily over 7 days and daunorubicin 45mg/m2 given on days 1, 2, and 3 of induction therapy. Patients with a complete response received reinduction with cytarabine at the same dose and infusion over 5 days with 2 doses of daunorubicin. After remission, patients who were socioculturoeconomically eligible for transplantation were evaluated for other prognostic factors, except for cytogenetic factors that were not available in the study center, to identify patients that were eligible for stem cell transplantation. Results: Patients were 17 to 60 years of age. 6 patients had early death due to complications and treatment failure. 39 patients (87%) achieved complete remission. Only 16 patients were eligible for transplantation on evaluation and underwent allogeneic stem-cell transplantation. 18 patients were not eligible for this transplantation and underwent consolidation therapy with chemotherapy. 5 patients did not receive any treatment and died during the follow up. In the follow up period between April 2006 and January 2014 in 39 out of 45 patients (min 0.2 yr, max 7. 8 yr) 31 % of patients were alive. Conclusions: Modified intermediate dose cytarabine was effective for the treatment of AML, achieving a high rate of complete remission, and might improve outcomes in patients.