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Comparison of high-dose cytarabine and timed-sequential chemotherapy as consolidation for younger adults with AML in first remission: the ALFA-9802 study.
- Source :
-
Blood [Blood] 2011 Aug 18; Vol. 118 (7), pp. 1754-62. Date of Electronic Publication: 2011 Jun 20. - Publication Year :
- 2011
-
Abstract
- To assess the value of administering timed-sequential chemotherapy (TSC; 2 therapeutic sequences separated by a 4-day interval-free chemotherapy) or high-dose cytarabine (HDAraC) cycles in consolidation therapy for acute myeloid leukemia (AML), 459 patients 15 to 50 years of age were enrolled in the prospective randomized Acute Leukemia French Association-9802 trial. Complete remission was achieved in 89%. A total of 237 patients were then randomized to either TSC consolidation (120 patients) or HDAraC consolidation cycles (117 patients). Overall, there was no significant difference between the 2 consolidation arms (5-year event-free survival [EFS]: 41% for HDAraC vs 35% for TSC), or cumulative incidence of relapse, or treatment-related mortality. Cytogenetically normal AML NPM1(+) or CEBPA(+) and FLT3-ITD(-) had the same outcome as those with favorable cytogenetics. When considering favorable and unfavorable risk groups, the trend was in favor of HDAraC. However, the difference became significant when considering intermediate cytogenetics (5-year EFS: 49% vs 29%; P = .02), especially cytogenetically normal AML (5-year EFS: 48% vs 31%; P = .04), which was related to lower relapse rate and less toxicity. This study demonstrates that TSC did not produce any benefit when used as consolidation therapy in younger adults compared with HDAraC. This trial was registered at www.clinicaltrials.gov as #NCT00880243.
- Subjects :
- Adolescent
Adult
Age Factors
Cytogenetic Analysis
Disease-Free Survival
Drug Therapy methods
Humans
Leukemia, Myeloid, Acute genetics
Leukemia, Myeloid, Acute therapy
Middle Aged
Nucleophosmin
Prospective Studies
Remission Induction
Young Adult
Antimetabolites, Antineoplastic administration & dosage
Antimetabolites, Antineoplastic therapeutic use
Cytarabine administration & dosage
Cytarabine therapeutic use
Leukemia, Myeloid, Acute drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 118
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 21690555
- Full Text :
- https://doi.org/10.1182/blood-2011-04-349258