Comparison of 60 or 90 mg/m<sup>2</sup> of daunorubicin in induction therapy for acute myeloid leukemia with intermediate or unfavorable cytogenetics

Devillier, Raynier; Bertoli, Sarah; Prébet, Thomas; Huguet, Françoise; Etienne, Anne; Charbonnier, Aude; Rey, Jérôme; Delabesse, Éric; D’Incan, Evelyne; Huynh, Anne; Blaise, Didier; Récher, Christian; Vey, Norbert

doi:10.1002/ajh.23884

Cited by 16 publications

(11 citation statements)

References 14 publications

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“…This suggests that both dose-intensity and timing of administration (e.g., the highest dose early in the therapeutic course) could be critical for the activity of anthracyclines. Furthermore, we and other have previously shown that a 60 mg/m 2 dose of daunorubicin was equivalent to 90 mg/m 2 but inferior to idarubicin 13 , 30 , 31 . Whether idarubicin (45 mg/m 2 ) is better than daunorubicin (270 mg/m 2 ) during induction only remains to be determined and is currently tested in a phase 3 trial of the ALFA/FILO French intergroup (Backbone InterGroup-1 trial, BIG-1, ClinicalTrials.gov: NCT02416388).…”

Section: Discussionmentioning

confidence: 55%

Improved outcome for AML patients over the years 2000–2014

Bertoli

Tavitian

Huynh

et al. 2017

Blood Cancer Journal

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Few recent studies from registries have reported an improvement in overall survival of younger patients with acute myeloid leukemia (AML). However, reasons for this improvement are not defined. We analyzed the therapeutic course and outcome of 976 patients treated by intensive chemotherapy between 2000 and 2014. The number of patients receiving allogeneic stem cell transplantation in first or second response significantly increased over time whereas autologous transplantation was progressively abandoned. In the 513 younger patients, there were no differences in first complete response, induction failure, incidence of relapse, or non-relapse mortality over time. The period of time was significantly associated with a better overall survival especially in 2010–2014. The 2010–2014 period effect was still significant in multivariate analysis and was independent of allogeneic stem cell transplantation. In the 463 older patients, there was a significant interaction between the period and leukocytosis in multivariate analysis meaning that the 2010–2014 period had only an impact in patients with white blood cell count >50 giga/L for response and overall survival. Progresses have been made in each phase of the therapeutic course of younger AML patients resulting in survival improvement. In older patients, the outcome of hyperleukocytic patients has significantly improved in 2010–2014.

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Section: Discussionmentioning

confidence: 55%

Improved outcome for AML patients over the years 2000–2014

Bertoli

Tavitian

Huynh

et al. 2017

Blood Cancer Journal

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“…Abbreviations: NR: not reached; MDS: myelodysplastic syndrome; NHL: non-Hodgkin lymphoma.*According to MRC classification [37]. …”

Section: Resultsmentioning

confidence: 99%

“…The cytogenetic classification for AML was in accordance with the Medical Research Council classification [33]. Treatment of AML has been described previously [30, 35–37]. …”

Section: Methodsmentioning

confidence: 99%

Therapy-related acute myeloid leukemia following treatment of lymphoid malignancies

et al. 2016

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Therapy-related acute myeloid leukemia (t-AML) is a heterogeneous entity most frequently related to breast cancer or lymphoproliferative diseases (LD). Population-based studies have reported an increased risk of t-AML after treatment of lymphomas. The aim of this study was to describe the characteristics and outcome of 80 consecutive cases of t-AML following treatment of LD. t-AML accounted for 2.3% of all AML cases, occurred 60 months after LD diagnosis, and were characterized by a high frequency of FAB M6 AML and poor-risk cytogenetic abnormalities. Time to t-AML diagnosis was influenced by patient age, type of LD, and treatment. Among the 48 t-AML patients treated with intensive chemotherapy, median overall survival (OS) was 7.7 months compared to 26.1 months in de novo, 4.2 months in post-myeloproliferative neoplasm, 9.4 months in post-myelodysplastic syndrome, 8.6 months in post-chronic myelomonocytic leukemia AML, 13.4 months in t-AML secondary to the treatment of solid cancer, and 14.7 months in breast cancer only. OS of post-LD t-AML patients was significantly influenced by age, performance status, myelodysplastic syndrome prior to LD/t-AML, and treatment regimen for LD. Thus, t-AML following lymphoid malignancies treatment should be considered as very high-risk secondary AML. New treatment strategies in patients with LD/t-AML are needed urgently.

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“…The only similar study for comparison of the effects of intermediate dose 60 mg/m 2 of daunorubicin with high dose (90 mg/m 2 ) is performed by Devillier et al . in a retrospective study of 300 consecutive patients with previously untreated AML who received induction therapy in Marseille and Toulouse . They suggest that a dose of 90 mg/m 2 of daunorubicin did not confer further benefit as compared with the intermediate dose of 60 mg/m 2 in the setting of patients without favourable cytogenetic.…”

Section: Discussionmentioning

confidence: 97%

Comparison of 60 and 80 mg/m² of daunorubicin in induction therapy of acute myeloid leukaemia

Vaezi

Bahar

Mousavi

et al. 2015

Hematological Oncology

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For finding better method of acute myeloid leukaemia (AML) induction, we designed a prospective clinical trial to find a more effective regimen with least toxicity for induction therapy of AML. Hence, we examined different accepted doses of daunorubicin and their outcomes. Total of 114 patients were included in the study. Fifty-five patients received 60 mg/m 2 of daunorubicin (arm 1) 1 h IV infusion for 3 days, and the remaining 59 received 80 mg/m 2 (arm 2) 1 h IV infusion for 3 days. Continuous infusion of 100 mg/m 2 /day of cytosine arabinozide IV for 24 h for 7 days was given in both groups. Complete remission rate was 77.78% in group 1 and 76.92% in group 2 (p = 0.92). One-year overall survival was 55.85% [standard error (SE) = 8.05%] in arm 1 and 57.94% (SE = 7.32%) in arm 2. Median follow-up time was 11.1 (SE = 1.43) and 10.28 (SE = 1.29) months, respectively. One-year disease-free survival was 64.41% (SE = 7.39%) in arm 1 and 54.86% (SE = 7.53%) in arm 2. Complete remission, overall survival and disease-free survival were statistically the same in both groups (p = 0.92, 0.697, 0.31). Toxicity and safety profile were similar in two groups but need to transfusion was higher in arm 2. Febrile neutropenia, days of antibiotics consumption and invasive fungal infection prevalence did not show any difference. Mean transfused packed cells and platelets rate were higher in the group that received higher dose of daunorubicin. Considering these results, we found that 60 mg/m 2 of daunorubicin would be more rational and as effective with lower toxicity to 80 mg/m 2 in induction therapy of AML patients at least as scheduled in our trial.

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Comparison of 60 or 90 mg/m² of daunorubicin in induction therapy for acute myeloid leukemia with intermediate or unfavorable cytogenetics

Cited by 16 publications

References 14 publications

Improved outcome for AML patients over the years 2000–2014

Improved outcome for AML patients over the years 2000–2014

Therapy-related acute myeloid leukemia following treatment of lymphoid malignancies

Comparison of 60 and 80 mg/m² of daunorubicin in induction therapy of acute myeloid leukaemia

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Comparison of 60 or 90 mg/m2 of daunorubicin in induction therapy for acute myeloid leukemia with intermediate or unfavorable cytogenetics

Cited by 16 publications

References 14 publications

Improved outcome for AML patients over the years 2000–2014

Improved outcome for AML patients over the years 2000–2014

Therapy-related acute myeloid leukemia following treatment of lymphoid malignancies

Comparison of 60 and 80 mg/m2 of daunorubicin in induction therapy of acute myeloid leukaemia

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Comparison of 60 or 90 mg/m² of daunorubicin in induction therapy for acute myeloid leukemia with intermediate or unfavorable cytogenetics

Comparison of 60 and 80 mg/m² of daunorubicin in induction therapy of acute myeloid leukaemia