The effects of idarubicin versus other anthracyclines for induction therapy of patients with newly diagnosed leukaemia

Xi, Li; Xu, Shuangnian; Tan, Ya Hwee; Chen, Jieping

doi:10.1002/14651858.cd010432.pub2

Cited by 32 publications

(28 citation statements)

References 82 publications

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“…While several anthracycline derivatives have been evaluated in clinical trials, only epirubicin (123) and idarubicin (124) received approval for clinical use. However, a critical analysis by Cochrane database identified no difference in cardiotoxicity between epirubicin and doxorubicin at equipotent doses (125).…”

Section: Hfmentioning

confidence: 99%

Cardiovascular Complications of Cancer Therapy

Chang

Moudgil

Scarabelli

et al. 2017

Journal of the American College of Cardiology

315

131

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Modern cancer therapy has successfully cured many cancers and converted a terminal illness to chronic disease. Because cancer patients often have co-existing heart diseases, expert advice from the cardiologists will improve clinical outcome. In addition, cancer therapy can also cause myocardial damage, induce endothelial dysfunction, and alter cardiac conduction. Thus, it is important for practicing cardiologists to be knowledgeable about the diagnosis, prevention, and management of cardiovascular complications of cancer therapy. In this first part of a 2-part review, we will review cancer therapy-induced cardiomyopathy and ischemia. This review is based on MEDLINE literature search, published clinical guidelines, and best practices in major cancer centers. With the number of cancer survivors expanding quickly, the time has come for cardiologists to work closely with cancer specialists to prevent and treat cancer therapy-induced cardiovascular complications.

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Section: Hfmentioning

confidence: 99%

Cardiovascular Complications of Cancer Therapy

Chang

Moudgil

Scarabelli

et al. 2017

Journal of the American College of Cardiology

315

131

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“…As such, patients with AML generally receive induction therapy independent of their subsequent risk stratification; the choice of induction regimen is based on the patient’s age and comorbidities, with ‘fit’ younger patients typically receiving standard induction therapy with cytarabine and an anthracycline 7 . Daunorubicin and idarubicin are the anthracyclines used most commonly in induction regimens, and neither agent is clearly superior to the other 17,18 . The findings of studies performed in the past decade, which are outlined in the following sections, indicate that molecular subtypes of AML correlate with improved responses to induction therapy in various subsets of patients, stressing the importance of integrating upfront comprehensive mutational profiling into initial treatment decisions.…”

Section: Genetic Profiling and Induction Therapymentioning

confidence: 99%

Molecular therapy for acute myeloid leukaemia

2015

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Acute myeloid leukaemia (AML) is a heterogeneous disease that is, in general, associated with a very poor prognosis. Multiple cytogenetic and molecular abnormalities that characterize different forms of AML have been used to better prognosticate patients and inform treatment decisions. Indeed, risk status in patients with this disease has classically been based on cytogenetic findings; however, additional molecular characteristics have been shown to inform risk assessment, including FLT3, NPM1, KIT, and CEBPA mutation status. Advances in sequencing technology have led to the discovery of novel somatic mutations in tissue samples from patients with AML, providing deeper insight into the mutational landscape of the disease. The majority of patients with AML (>97%) are found to have a clonal somatic abnormality on mutational profiling. Nevertheless, our understanding of the utility of mutation profiling in clinical practice remains incomplete and is continually evolving, and evidence-based approaches to application of these data are needed. In this Review, we discuss the evidence-base for integrating mutational data into treatment decisions for patients with AML, and propose novel therapeutic algorithms in the era of molecular medicine.

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“…No comparison data on cardiotoxicity in children is available (Li et al, 2015). No difference has been reported in remission data compared to idarubicin.…”

Section: Doxorubicinmentioning

confidence: 99%

“…No difference has been reported in remission data compared to idarubicin. No comparison data on cardiotoxicity in children is available (Li et al, 2015).…”

Section: Doxorubicinmentioning

confidence: 99%

“…Idarubicin has been shown to improve blast cell reduction in induction therapy in paediatric AML, but it did not have any effect on overall survival (Creutzig et al, 2001a). In a Cochrane review including studies of both adult and paediatric AML, idarubicin had better results compared with daunorubicin concerning complete remission rate, overall survival and disease-free survival in the induction therapy of patients with newly diagnosed AML (Li et al, 2015).…”

Section: Doxorubicinmentioning

confidence: 99%

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Is it possible to cure childhood acute myeloid leukaemia without significant cardiotoxicity?

2016

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Since cardiotoxicity is a life threatening late effect, a reduction of cardiotoxicity in the treatment of acute myeloid leukaemia (AML) is essential. This review is a compilation of the current knowledge about cardiotoxicity after AML treatment and of how future directions in treatment may affect its incidence. A total of six studies concerning AML and cardiotoxicity were identified. The incidence of late subclinical cardiotoxicity varied between 1·3 and 15·3%, and late clinical cardiotoxicity varied between 1·3 and 9·3%. Cumulative dose of anthracyclines (ACs) and history of relapse were the most common risk factors identified. No conclusions could be drawn about new, potentially less toxic ACs. Differences in treatment data and variations in study populations made comparisons uncertain. The echocardiographic techniques used in the majority of the studies are inferior to more modern echocardiographic methods. This decreases reproducibility and may increase the risk of overestimation of cardiotoxicity. In summary, AML cannot be cured today without ACs. However, some ACs may cause less cardiotoxicity than others. Furthermore there is currently no consensus on equipotent doses of ACs and risk factors for cardiotoxicity. Further research including randomized trials is needed to evaluate whether or not the potentially less cardiotoxic agents fulfil their promise.

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The effects of idarubicin versus other anthracyclines for induction therapy of patients with newly diagnosed leukaemia

Cited by 32 publications

References 82 publications

Cardiovascular Complications of Cancer Therapy

Cardiovascular Complications of Cancer Therapy

Molecular therapy for acute myeloid leukaemia

Is it possible to cure childhood acute myeloid leukaemia without significant cardiotoxicity?

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