Treatment of acute myelocytic leukemia: a study by cancer and leukemia group B

Rai, KR; Jf, Holland; Glidewell, O; Weinberg, V.; Brunner, K. W.; Obrecht, JP; Hd, Preisler; Nawabi, IW; Prager, David; Rw, Carey; Cooper, Andrea M.; Haurani, Farid I.; Hutchison, JL; Silver, RT; Falkson, Geoffrey; Wiernik, Peter H.; Hoagland, H. Clark; Cd, Bloomfield; James, G. Watson; Gottlieb, Arlan J.; Sv, Ramanan; Blom, Johannes; Ni, Nissen; Bank, Arthur; Ellison, RR; Kung, Faith; Henry, Patrick H.; McIntyre, O. Ross; Kaan, SK

doi:10.1182/blood.v58.6.1203.bloodjournal5861203

Cited by 183 publications

(30 citation statements)

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“…Improved LFS and better 5‐year OS were evident in our study as compared with previous published work from our institution (between 1994 and 2003) . The 5‐year survival in our study was also comparable to the initial CALGB study and other single institutional studies . Pulte et al .…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcomes for patients with acute myeloid leukemia: A single‐center experience from AIIMS, India

Bahl

Sharma

Raina

et al. 2015

Asia-Pac J Clncl Oncology

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Section: Discussionmentioning

confidence: 99%

Long‐term outcomes for patients with acute myeloid leukemia: A single‐center experience from AIIMS, India

Bahl

Sharma

Raina

et al. 2015

Asia-Pac J Clncl Oncology

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“…All patients received first‐line therapy with standard induction regimens including idarubicin and cytarabine, idarubicin and high‐dose cytarabine or daunorubicin and cytarabine. Dosing and schedules were as previously described; idarubicin 12 mg/m 2 /day, days 1–3; cytarabine 100 mg/m 2 /day, days 1–7 [11–13]; idarubicin 12 mg/m 2 /days, days 1–3; and cytarabine 3000 mg/m 2 every 12 hr, days 1–4; [14] daunorubicin 45 mg/m 2 /day, days 1–3 and cytarabine 100 mg/m 2 /day, days 1–7 [15]. Among patients who obtained a CR to induction, postremission therapy consisted of two cycles of idarubicin or daunorubicin and cytarabine or four cycles of high‐dose cytarabine.…”

Section: Methodsmentioning

confidence: 99%

Second‐line mitoxantrone, etoposide, and cytarabine for acute myeloid leukemia: A single‐center experience

Kohrt

Patel

et al. 2010

American J Hematol

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The majority of patients with acute myeloid leukemia (AML) will require second-line chemotherapy for either relapsed or refractory disease. Currently, only allogeneic hematopoietic cell transplantation (HCT) offers a curative option in this setting and no preferred regimen has been established. The reported efficacy of second-line regimens is widely disparate, thus limiting informed clinical decision making. A retrospective review of 77 patients receiving therapy between 2001 and 2008 with relapsed, 42, and refractory, 35, AML was performed to determine overall response rate and survival following mitoxantrone (8 mg/m 2 /day), etoposide (100 mg/m 2 /day), and cytarabine (1,000 mg/m 2 /day) chemotherapy administered over 5 days. Among 77 patients (median age of 54 years and 64% intermediate risk karyotype) with median follow-up of 153 days, 18% achieved a complete response and 8% a morphologic leukemia-free state. Fifty-seven (74%) experienced treatment failure, 10 of whom achieved a remission after additional therapy. Median overall survival (OS) was 6.8 months. Among patients achieving a response, 50% received consolidation with allogeneic HCT, autologous HCT (5%), or consolidation chemotherapy alone (45%). A nonsignificant trend in overall response (50%, 27%, and 23.8%) and median OS (8.3, 6.8, and 4.7 months) was observed by cytogenetic stratification into favorable, intermediate, and unfavorable risk. Patients with refractory versus relapsed disease had similar overall responses (20% and 31%, P 5 0.41) and median OS (5.3 and 7.6 months, P 5 0.36). Despite risk stratification by the European Prognostic Index, our series demonstrates inferior rates of response and survival, illustrating the limited activity of this regimen in our cohort. Am. J. Hematol. 85:877-881, 2010. V V C 2010 Wiley-Liss, Inc. IntroductionAlthough intensive induction chemotherapy is effective in inducing a complete response (CR) in 50-80% of young (<60 years old) patients with acute myeloid leukemia (AML), the majority obtaining a CR eventually relapse and subsequently succumb to their disease [1][2][3]. Allogeneic hematopoietic cell transplantation (HCT) is generally accepted as the only curative approach for relapsed or refractory disease [4]. However, second-line HCT is limited by availability of an appropriately matched donor as well as transplant-related morbidity and mortality particularly among older or heavily pretreated patients.Second-line chemotherapy regimens including mitoxantrone, etoposide, and cytarabine (MEC) have been commonly used to obtain disease control preceding HCT or as primary treatment for relapsed disease among patients not eligible for HCT [5]. When first introduced in 1991, the CR rate following second-line MEC was reported at 61-66% with 4-5-month median overall survival (OS) [5,6]. However, in two recent phase III randomized trials, the response rates in the placebo arm to a single cycle of second-line MEC were only 19 and 28%, although OS was similar to the earlier studies, 5.4 and 5.2 months [7,8]. Becaus...

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“…AML leads to death in the first year when untreated but has high remission rates, especially in young patients, since the introduction of Daunorubicin and Cytarabine . Knowledge of the different appearances of this heterogeneous disease is therefore essential to enable early diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%