24 research outputs found
A randomized study of intermediate versus conventional-dose cytarabine as intensive induction for acute myelogenous leukaemia
The optimal dose of cytarabine for induction chemotherapy is unknown. Most studies have utilized doses of 100â200 mg/m2/d, although higher doses have been proposed to increase the concentration of the active metabolite araâCTP within leukaemia cells. To address this question 101 adults with newly diagnosed acute myeloid leukaemia were randomized to receive treatment with daunorubicin and either conventionalâdose cytarabine (200 mg/m2/d by continuous infusion) or an intermediateâdose of cytarabine (500 mg/m2 every 12 h). 36/51 (71%) patients assigned to conventionalâdose cytarabine achieved complete remission compared to 37/50 (74%) who achieved remission with intermediateâdose cytarabine (P = 0.9). Patient age significantly affected remission rate. 8/17 patients age >60 assigned to conventionalâdose cytarabine and 10/17 assigned to intermediateâdose 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 4âyear diseaseâfree survival for patients assigned to conventionalâdose cytarabine was 20.16% versus 28.17% for patients assigned to intermediateâdose cytarabine (P=0â9). We conclude that intermediate dose cytarabine did not substantially improve results of induction chemotherapy for acute myeloid leukaemia