A randomized study of intermediate verus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia

G. Schiller, J. Gajewski, S. Nimer, M. Territo, W. Ho, M. Lee, R. Champlin

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Abstract

The optimal dose of cytarabine for induction chemotherapy is unknown. Most studies have utilized doses of 100-200 mg/m2/d, although higher doses have been proposed to increase the concentration of the active metabolite ara-CTP within leukaemia cells. To address this question 101 adults with newly diagnosed acute myeloid leukaemia were randomized to receive treatment with daunorubicin and either conventional-dose cytarabine (200 mg/m2/d by continuous infusion) or an intermediate-dose of cytarabine (500 mg/m2 every 12 h). 36/51 (71%) patients assigned to conventional-dose cytarabine achieved complete remission compared to 37/50 (74%) who achieved remission with intermediate-dose cytarabine (P = 0.9). Patient age significantly affected remission rate. 8/17 patients age > 60 assigned to conventional-dose cytarabine and 10/17 assigned to intermediate-dose cytarabine achieved complete remission compared to 27/33 patients under age 60 assigned to the conventional dose and 28/34 patients assigned to the intermediate dose arm (P = 0.004). Actuarial 4-year disease-free survival for patients assigned to conventional-dose cytarabine was 20 ± 16% versus 28 ± 17% for patients assigned to intermediate-dose cytarabine (P = 0.9). We conclude that intermediate dose cytarabine did not substantially improve results of induction chemotherapy for acute myeloid leukaemia.

Original languageEnglish (US)
Pages (from-to)170-177
Number of pages8
JournalBritish Journal of Haematology
Volume81
Issue number2
StatePublished - 1992
Externally publishedYes

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Cytarabine
Acute Myeloid Leukemia
Induction Chemotherapy
Arabinofuranosylcytosine Triphosphate
Daunorubicin
Disease-Free Survival
Leukemia

ASJC Scopus subject areas

  • Hematology

Cite this

Schiller, G., Gajewski, J., Nimer, S., Territo, M., Ho, W., Lee, M., & Champlin, R. (1992). A randomized study of intermediate verus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia. British Journal of Haematology, 81(2), 170-177.

A randomized study of intermediate verus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia. / Schiller, G.; Gajewski, J.; Nimer, S.; Territo, M.; Ho, W.; Lee, M.; Champlin, R.

In: British Journal of Haematology, Vol. 81, No. 2, 1992, p. 170-177.

Research output: Contribution to journalArticle

Schiller, G, Gajewski, J, Nimer, S, Territo, M, Ho, W, Lee, M & Champlin, R 1992, 'A randomized study of intermediate verus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia', British Journal of Haematology, vol. 81, no. 2, pp. 170-177.
Schiller, G. ; Gajewski, J. ; Nimer, S. ; Territo, M. ; Ho, W. ; Lee, M. ; Champlin, R. / A randomized study of intermediate verus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia. In: British Journal of Haematology. 1992 ; Vol. 81, No. 2. pp. 170-177.
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