High-dose cytarabine improves outcome in patients with AML in EORTC-GIMEMA AML-12 Trial

December 19, 2013

Results of the EORTC and GIMEMA (Gruppo Italiano Malattie Ematologiche dell' Adulto) AML-12 Trial appearing in the Journal of Clinical Oncology show that high-dose cytarabine in induction treatment improves outcome of adult patients with acute myeloid leukemia (AML). In particular, high-dose cytarabine produces higher remission and survival rates than the standard-dose cytarabine in patients younger than age 46 years old.

Dr. Roelof Willemze of the Leiden University Medical Centre and lead author of this report explains, "The most commonly administered induction regimen for with AML is a daily dose of 100 to 200 mg/m2 of cytarabine for seven to ten days in combination with three days of an anthracycline. This treatment has been shown to result in complete remission rates of 60% to 80% depending on age of the patient as well as genetic and molecular characteristics of the disease. Up until now, however, we did not have clear consensus on the benefit of higher dosages of cytarabine."

The AML-12 included 1,942 newly diagnosed patients with AML aged 15 to 60 years and compared remission induction treatment with daunorubicin, etoposide, and either standard-dose (100 mg/m2 per day by continuous infusion for 10 days) or high-dose (3,000 mg/m2 every 12 hours by 3-hour infusion on days 1, 3, 5, and 7) cytarabine. Patients in complete remission received a single consolidation cycle containing daunorubicin and intermediate dose cytarabine.

At a median follow-up of six years, overall survival was 38.7% for patients receiving standard-dose and 42.5% for those receiving high-dose cytarabine (log-rank test P = 0.06; multivariable analysis P = 0.009).

For patients younger than 46 years old, survival was 43.3% with standard-dose treatment and 51.9% with high-dose treatment (P = 0.009; multivariable analysis P = 0.003). Survival for patients 46 to 60 years old was 33.9% and 32.9%, respectively (P = 0.91).

Complete remission rates were 72.0% for standard-dose and 78.7% for high-dose (P < 0.001). Patients younger than 46 years old had complete remission rates of 75.6% and 82.4%, respectively, (P = 0.01), while patients 46 years and older had rates of 68.3% and 74.8%, respectively (P = 0.03).

Explore further: Sequential GO and chemotherapy no benefit for older AML patients according to EORTC/GIMEMA trial

Related Stories

Sequential GO and chemotherapy no benefit for older AML patients according to EORTC/GIMEMA trial

October 22, 2013
Results of the randomized, phase III, EORTC/GIMEMA 06012 intergroup trial (AML-17) reported in the Journal of Clinical Oncology show that sequential combination of gemtuzumab ozogamicin (GO) and standard chemotherapy provides ...

Improved chemo regimen for childhood leukemia may offer high survival, no added heart toxicity

May 23, 2013
Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added ...

AML patients have high response rate with vorinostat added to treatment

December 13, 2011
Adding a drug that activates genes to frontline combination therapy for acute myeloid leukemia resulted in an 85 percent remission rate after initial treatment, researchers at The University of Texas MD Anderson Cancer Center ...

Study finds genes improving survival with higher chemo doses in leukemia

March 14, 2012
New research published in the March 15 issue of the New England Journal of Medicine identifies gene mutations associated with improved overall survival with higher doses of chemotherapy for patients with acute myeloid leukemia ...

Recommended for you

Researchers identify gene variants linked to a high-risk children's cancer

September 25, 2017
Pediatric researchers investigating the childhood cancer neuroblastoma have identified common gene variants that raise the risk of an aggressive form of that disease. The discovery may assist doctors in better diagnosing ...

Prostaglandin E1 inhibits leukemia stem cells

September 25, 2017
Two drugs, already approved for safe use in people, may be able to improve therapy for chronic myeloid leukemia (CML), a blood cancer that affects myeloid cells, according to results from a University of Iowa study in mice.

MRI contrast agent locates and distinguishes aggressive from slow-growing breast cancer

September 25, 2017
A new magnetic resonance imaging (MRI) contrast agent being tested by researchers at Case Western Reserve University not only pinpoints breast cancers at early stages but differentiates between aggressive and slow-growing ...

Cancer vaccines need to target T cells that can persist in the long fight against cancer

September 25, 2017
Cancer vaccines may need to better target T cells that can hold up to the long fight against cancer, scientists report.

Lung cancer treatment could be having negative health effect on hearts

September 25, 2017
Radiotherapy treatment for lung cancer could have a negative effect on the health of your heart new research has found.

Alternative splicing, an important mechanism for cancer

September 22, 2017
Cancer, which is one of the leading causes of death worldwide, arises from the disruption of essential mechanisms of the normal cell life cycle, such as replication control, DNA repair and cell death. Thanks to the advances ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.