ORIGINAL ARTICLE |
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Year : 2018 | Volume
: 1
| Issue : 2 | Page : 61-65 |
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Intensified versus non-intensified induction therapy with cytarabine and daunorubicin for patients with newly diagnosed acute myeloid leukemia
Mehrzad Mirzania1, Sayyed Reza Safaee Nodehi1, Ramezan Ali Sharifian1, Farhad Shahi1, Amir Hosein Emami1, Mohsen Esfandbod1, Gholam Reza Togeh2, Sahar Tavakoli3
1 Hematology and Medical Oncology Department, Cancer Research Center, Cancer Institute of Iran, Imam Khomeini Hospital Complex, Tehran, Iran 2 Department of Hematology, Thrombosis Hemostasis Research Center, Tehran, Iran 3 Department of Hematology and Oncology, Hematopoietic Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Science (TUMS), Tehran, Iran
Correspondence Address:
Sahar Tavakoli Department of Hematology and Oncology, Hematopoietic Stem Cell Transplantation Research Center, Shariati Hospital, North Kargar Street, Tehran Iran
Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JCO.JCO_8_18
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Background: The purpose of this study was to compare the efficacy and adverse effects of intensified dose of daunorubicin (DNR) and cytarabine (Ara-C) versus their standard dose in induction therapy for patients with newly diagnosed acute myeloid leukemia (AML). Materials and Methods: In a retrospective review, patients with AML in Hematology and Oncology Department of Imam Khomeini Hospital, Tehran, Iran, who underwent induction therapy with standard dose of Ara-C and DNR (100mg/m2 for 7 days and 45mg/m2 for 3 days, respectively) were compared in terms of overall survival (OS) rate, disease-free survival (DFS) rate, and treatment-related complications with those who underwent double-intensified induction (i.e., Ara-C, 200mg/m2 for 7 days and DNR, 60mg/m2 for 3 days). Results: Among 123 patients, the standard-dose regimen was used for 49 patients, and 74 patients received the dose-intensified regimen. The rate of 2-year DFS, 2-year recurrence rate of the disease, and treatment-related mortality improved significantly in the latter group (P < 0.05). However, between the two groups, OS rate, bone marrow blast cell percentage 14 days after treatment, the number of antibiotics received, fungal infection rate, and the need for bone marrow transplants did not significantly differ. On the other hand, the risk of heart failure significantly increased in the dose-intensified group (P < 0.05). Conclusion: Treatment of AML using combined dose-intensified induction significantly improved DFS rate and decreased the disease-recurrence rate but did not significantly improve OS rate, and more side effects were encountered. |
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