Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Proceedings Article
  • Published:

Optimal induction and post-remission therapy for acute myeloid leukemia

Leukemia Supplements volume 1, pages S14–S15 (2012)Cite this article

Abstract

The approach to treatment of acute myeloid leukemia is substantially influenced by the age of the patient. Younger patients who are arbitrarily defined as those being <60 years, although comprising the minority of all patients with the disease, will always receive an intensive approach, whereas in older patients, an initial decision as to whether an intensive approach is appropriate or not has to be made. Standard chemotherapy for many years has been ‘3+7’, followed by consolidation with high-dose Ara-C at a daily dose level of 3 g/m2. It remains unclear as to what number of total treatment courses is optimal. Alternatives to this standard of care will be considered.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Fernandez HF, Sun Z, Yao X, Litzow MR, Luger SM, Paietta EM et al. Anthracycline dose intensification in acute myeloid leukemia. N Engl J Med 2009; 361: 1249–1259.

    Article  CAS  Google Scholar 

  2. Lowenberg B, Ossenkoppele GJ, van Putten W, Schouten HC, Graux C, Ferrant A et al. High-dose daunorubicin in older patients with acute myeloid leukemia. N Engl.J Med 2009; 361: 1235–1248.

    Article  Google Scholar 

  3. Lee JH, Joo YD, Kim H, Bae SH, Kim MK, Zang DY et al. A randomized trial comparing standard versus high-dose daunorubicin induction in patients with acute myeloid leukemia. Blood 2011; 118: 3832–3841.

    Article  CAS  Google Scholar 

  4. Pautas C, Merabet F, Thomas X, Raffoux E, Gardin C, Corm S et al. Randomized study of intensified anthracycline doses for induction and recombinant interleukin-2 for maintenance in patients with acute myeloid leukemia age 50 to 70 years: results of the ALFA-9801 study. J Clin Oncol 2010; 28: 808–814.

    Article  CAS  Google Scholar 

  5. Ohtake S, Miyawaki S, Fujita H, Kiyoi H, Shinagawa K, Usui N et al. Randomized study of induction therapy comparing standard-dose idarubicin with high-dose daunorubicin in adult patients with previously untreated acute myeloid leukemia: the JALSG AML201 Study. Blood 2011; 117: 2358–2365.

    Article  CAS  Google Scholar 

  6. Petersdorf S, Kopecky K, Stuart RK, Larson RA, Nevill TJ, Stenke L et al. Preliminary results of Southwest Oncology Group Study S0106: an international intergroup phase 3 randomized trial comparing the addition of gemtuzumab ozogamicin to standard induction therapy versus post-consolidation gemtuzumab ozogamicin versus no additional therapy for previously untreated acute myeloid leukemia. Blood 2009; 114: 326–327.

    Article  Google Scholar 

  7. Burnett AK, Hills RK, Milligan D, Kjeldsen L, Kell J, Russell NH et al. Identification of patients with acute myeloblastic leukemia who benefit from the addition of gemtuzumab ozogamicin: results of the MRC AML15 Trial. J Clin Oncol 2011; 29: 369–377.

    Article  CAS  Google Scholar 

  8. Castaigne S, Pautas C, Terre C, Raffoux E, Bordessoule D, Bastie J-N et al. Effect of gemtuzumab ozogamicin on survival of adult patients with de-novo acute myeloid leukaemia (ALFA-0701): a randomised, open-label, phase 3 study. Lancet 2012; 379: 1508–1516.

    Article  CAS  Google Scholar 

  9. Burnett AK, Russell N, Hills RK, Kell J, Freeman S, Kjeldsen L et al. The addition of gemtuzumab ozogamicin to induction chemotherapy improves survival in older patients with acute myeloid leukaemia. J Clin Oncol 2012 (in press).

  10. Hołowiecki J, Grosicki S, Kyrcz-Krzemien S, Skotnicki AB, Piatkowska-Jakubas B, Warzocha K et al. Daunorubicin, cytarabine and fludarabine (DAF) for remission induction in relapsed or refractory acute myeloid leukemia. Evaluation of safety, tolerance and early outcome—Polish Adult Leukemia Group (PALG) pilot study. Ann Hematol 2008; 87: 361–367.

    Article  Google Scholar 

  11. Holowiecki J, Grosicki S, Giebel S, Robak T, Kyrcz-Krzemien S, Kuliczkowski K et al. Cladribine, but not fludarabine, added to daunorubicin and cytarabine during induction prolongs survival of patients with Acute Myeloid Leukemia. Multicenter, Randomized Phase III Study. J Clin Oncol; e-pub ahead of print 16 April 2012.

  12. Mayer RJ, Davis RB, Schiffer CA, Berg DT, Powell BL, Schulman P et al. Intensive postremission chemotherapy in adults with acute myeloid-leukemia. N Engl J Med 1994; 331: 896–903.

    Article  CAS  Google Scholar 

  13. Burnett AK, Milligan D, Goldstone A, Prentice A, McMullin MF, Dennis M et al. The impact of dose escalation and resistance modulation in older patients with acute myeloid leukaemia and high risk myelodysplastic syndrome: the results of the LRF AML14 trial. Br J Haematol 2009; 145: 318–332.

    Article  CAS  Google Scholar 

  14. Brune M, Castaigne S, Catalano J, Gehlsen K, Ho AD, Hofmann WK et al. Hellstrand. Improved leukemia-free survival after postconsolidation immunotherapy with histamine dihydrochloride and interleukin-2 in acute myeloid leukemia: results of a randomized phase 3 trial. Blood 2006; 108: 88–96.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology, School of Medicine, Cardiff University, Heath Park, UK

    A K Burnett

Authors
  1. A K Burnett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A K Burnett.

Ethics declarations

Competing interests

The author has received consulting fees and grant support from Genzyme. This article was published as part of a supplement that was supported by Novartis, MSD Italia, Roche, Celgene, GlaxoSmithKline, Sanofi, Gilead, Adienne, Italfarmaco, Pierre Fabre Pharmaceuticals with an unrestricted educational contribution to AREO—Associazione Ricerche Emato-Oncologiche (Genoa) and AMS—Associazione Malattie del Sangue (Milan) for the purpose of advancing research in acute and chronic leukemia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burnett, A. Optimal induction and post-remission therapy for acute myeloid leukemia. Leukemia Suppl 1 (Suppl 2), S14–S15 (2012). https://doi.org/10.1038/leusup.2012.10

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/leusup.2012.10

Keywords

Search

Advanced search

Quick links