Mitoxantrone versus daunorubicin in induction-consolidation chemotherapy--the value of low-dose cytarabine for maintenance of remission, and an assessment of prognostic factors in acute myeloid leukemia in the elderly: final report. European Organization for the Research and Treatment of Cancer and the Dutch-Belgian Hemato-Oncology Cooperative Hovon Group.

• DOI: 10.1200/jco.1998.16.3.872
• Publication Date: 2017-02-24T10:01:33Z
• Authors: B Löwenberg; S Suciu; E Archimbaud; H Haak; P Stryckmans; R de Cataldo; A W Dekker; Z N Berneman; A Thyss; J van der Lelie; P Sonneveld; G Visani; G Fillet; M Hayat; A Hagemeijer; G Solbu; R Zittoun
• Keywords: Mitoxantrone; Daunorubicin; Induction chemotherapy

PURPOSE AND METHODS Optimization of remission-induction and postremission therapy in elderly individuals with acute myeloid leukemia (AML) was the subject a randomized study patients older than 60 years. Remission-induction chemotherapy compared between daunomycin (DNR) 30 mg/m2 on days 1, 2, 3 versus mitoxantrone (MTZ) 8 3, both plus cytarabine (Ara-C) 100 1 to 7. Following complete remission (CR), received one additional cycle DNR or MTZ were then eligible for second randomization eight cycles low-dose (LD)-Ara-C 10 subcutaneously every 12 hours 2 6 weeks no further treatment. RESULTS A total 242 247 MTZ. Median age groups 68 Secondary AML documented 26% 25% either arm. The probability attaining CR greater (P = .069) (47%) (38%). duration neutropenia 19 22 (MTZ). response rate correlated reduced occurrence resistance (32% v 47%, P .001). With median follow-up years, 5-year disease-free survival (DFS) is 8% each Overall estimates are not different (6% 9% at 5 yrs). Poor performance status diagnosis, high WBC count, age, secondary AML, presence cytogenetic abnormalities all had an adverse impact survival. abnormal cytogenetics predicted shorter CR. Among responders, 74 assessable assigned Ara-C 73 therapy. Actuarial DFS significantly longer .006) Ara-C-treated (13% [SE 4.0%] years) nontreated (7% 3%]), but overall similar .29): 18% (SE 4.6%) 15% 4.3%). Meta-analysis value confirms these results. CONCLUSION In previously untreated induction produces slightly better does DNR-containing regimen, it has significant effect maintenance may prolong DFS, did improve