1. Intensive consolidation therapy compared with standard consolidation and maintenance therapy for adults with acute myeloid leukaemia aged between 46 and 60 years: final results of the randomized phase III study (AML 8B) of the European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell’Adulto (GIMEMA) Leukemia Cooperative Groups
- Author
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Paola Fazi, Franco Mandelli, Luigi Resegotti, Pietro Leoni, Sergio Amadori, Joseph Thaler, Jean-Pierre Marie, Marco Vignetti, Marysia Hengeveld, Theo de Witte, Giorgina Specchia, Matthias Karrasch, Bruno Rotoli, Robert Zittoun, Maria Concetta Petti, Enrica Morra, Guiseppe Fioritoni, Stefan Suciu, and Petra Muus
- Subjects
Myeloid ,Male ,International Cooperation ,Medical Oncology ,administration /&/ dosage/therapeutic use ,organization /&/ administration ,0302 clinical medicine ,Maintenance therapy ,Post-remission chemotherapy ,hemic and lymphatic diseases ,Antineoplastic Combined Chemotherapy Protocols ,polycyclic compounds ,Medicine & Public Health ,Societies, Medical ,0303 health sciences ,Leukemia ,Incidence (epidemiology) ,Translational research Immune Regulation [ONCOL 3] ,Age Factors ,Induction Chemotherapy ,Hematology ,General Medicine ,Middle Aged ,drug therapy ,3. Good health ,Europe ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Italy ,Oncology ,030220 oncology & carcinogenesis ,methods/standards ,Female ,Original Article ,medicine.drug ,Adult ,medicine.medical_specialty ,Adolescent ,Daunorubicin ,Acute ,Acute myeloid leukaemia ,methods/organization /&/ administration ,methods ,Maintenance Chemotherapy ,Young Adult ,03 medical and health sciences ,Translational research [ONCOL 3] ,Medical ,Internal medicine ,medicine ,Humans ,neoplasms ,Survival rate ,Adolescent, Adult, Age Factors, Antineoplastic Combined Chemotherapy Protocols ,administration /&/ dosage/therapeutic use, Consolidation Chemotherapy ,methods/standards, Europe, Female, Hematology ,methods/organization /&/ administration, Humans, Induction Chemotherapy ,methods, International Cooperation, Italy, Leukemia ,drug therapy, Maintenance Chemotherapy ,methods/standards, Male, Medical Oncology ,methods/organization /&/ administration, Middle Aged, Societies ,organization /&/ administration, Treatment Outcome, Young Adult ,030304 developmental biology ,business.industry ,Induction chemotherapy ,Consolidation Chemotherapy ,medicine.disease ,Surgery ,Cytarabine ,Societies ,business ,Settore MED/15 - Malattie del Sangue - Abstract
Item does not contain fulltext The most effective post-remission treatment to maintain complete remission (CR) in adults aged between 46 and 60 years with acute myeloid leukaemia (AML) is uncertain. Previously untreated patients with AML in CR after induction chemotherapy with daunorubicin and cytarabine were randomized between two intensive courses of consolidation therapy containing high-dose cytarabine, combined with amsacrine or daunorubicin and a standard consolidation and maintenance therapy containing standard dose cytarabine and daunorubicin. One hundred fifty-eight CR patients were assigned to the intensive group and 157 patients to the standard group. After a median follow-up of 7.5 years, the 4-year survival rate was 32 % in the intensive group versus 34 % in the standard group (P = 0.29). In the intensive group, the 4-year relapse incidence was lower than in the standard group: 55 and 75 %, respectively (P = 0.0003), whereas treatment-related mortality incidence was higher: 22 versus 3 % (P < 0.0001). Two intensive consolidation courses containing high-dose cytarabine as post-remission treatment in patients with AML aged between 46 and 60 years old did not translate in better long-term outcome despite a 20 % lower relapse incidence. Better supportive care and prevention of treatment-related complications may improve the overall survival after intensified post-remission therapy in this age group. 01 juni 2012
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- 2012