Idarubicin or Mitoxantrone, VP-16, and Cytarabine for Induction/Consolidation Therapy Followed by Autologous Stem Cell Transplantation in Elderly Patients with Acute Myeloid Leukemia: A Feasibility Study

Seventy-four patients of median age 70 years (range 61-83 years), with acute myeloid leukemia (AML) at diagnosis, 56 of them with de novo AML and 18 with AML secondary to primary myelodysplastic syndrome or toxic exposure (sAML), received inducton therapy with idarubicin, 8 mg/m2 per day on days 1, 3, and 5, or on a randomized basis, mitoxantrone, 7 mg/m2 per day on days 1, 3, and 5, both associated with VP-16, 100 mg/m2 per day on days 1-3 and cytarabine (ara-C), 100 mg/m2 per day, on days 1-7 Granulocyte colony stimulating factor (G-CSF), 5 µg/kg per day, was administered after chemotherapy in patients aged more than 70 years. Patients in complete remission (CR) received one course of consolidation using the same schedule as for induction except for the shortening of ara-C administration to 5 days. Patients aged less than 70 years were then scheduled to undergo autologous stem cell harvest on days 5-7 of G-CSF, 5 µg/kg per day, initiated after hematopoietic recovery from consolidation. Autologous transplantation was performed after conditioning with carmustine (BCNU), 800 mg/m2 or busulfan 16 mg/kg. GCSF was administered when neutrophils were