Single or Double Induction With 7 + 3 Containing Standard or High-Dose Daunorubicin for Newly Diagnosed AML: The Randomized DaunoDouble Trial by the Study Alliance Leukemia

医学 柔红霉素 诱导化疗 随机对照试验 内科学 白血病 肿瘤科 外科 化疗
作者
Christoph Röllig,Björn Steffen,Christoph Schliemann,Jan-Henrik Mikesch,Nael Alakel,Regina Herbst,Mathias Hänel,Richard Noppeney,Maher Hanoun,Martin Kaufmann,Barbora Weinbergerová,Kerstin Schäfer‐Eckart,Tim Sauer,Andreas Neubauer,Andreas Burchert,Claudia D. Baldus,Jolana Mertová,Edgar Jost,Dirk Niemann,Jan Novák
出处
期刊:Journal of Clinical Oncology [Lippincott Williams & Wilkins]
被引量:3
标识
DOI:10.1200/jco.24.00235
摘要

PURPOSE To determine the optimal daunorubicin dose and number of 7 + 3 induction cycles in newly diagnosed AML, this randomized controlled trial compared a once daily dose of 60 mg/m 2 with 90 mg/m 2 daunorubicin in the first 7 + 3 induction and one versus two cycles of 7 + 3 induction. PATIENTS AND METHODS Patients age 18-65 years with newly diagnosed AML were randomly assigned to 60 versus 90 mg/m 2 daunorubicin once daily plus cytarabine. Patients with marrow blasts below 5% on day 15 after first induction were randomly assigned to receive a second induction cycle or no second induction cycle. RESULTS Eight hundred and sixty-four patients with a median age of 52 years were randomly assigned. After a preplanned interim analysis showing no significant difference in response between 60 and 90 mg/m 2 , all consecutive patients received 60 mg/m 2 daunorubicin once daily. The proportion of good early responders was 44% versus 48% ( P = .983) with a composite complete remission (CRc) rate of 90% versus 89% after induction ( P = .691); the 3-year relapse-free survival (RFS) after 60 versus 90 mg/m 2 once daily was 54% versus 50% ( P = .561), and the 3-year overall survival (OS) was 65% versus 58% ( P = .242). Among 389 good responders, CRc rates at the end of induction were 87% after single induction and 85% after double induction. The 3-year RFS was 51% versus 60% (hazard ratio [HR], 1.3; P = .091), and the 3-year OS was 76% versus 75% after single versus double induction (HR, 1.0; P = .937). CONCLUSION The use of 90 mg/m 2 daunorubicin once daily in the context of classical 7 + 3 induction does not significantly improve early response and does not lead to higher remission rates or longer survival than 60 mg/m 2 once daily. In patients with a good early response after first induction, a second induction has only a limited impact on RFS and does not result in an OS benefit.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
李茵发布了新的文献求助10
1秒前
1秒前
2秒前
2秒前
wyl发布了新的文献求助10
3秒前
4秒前
4秒前
小小小值钱完成签到,获得积分20
6秒前
wangjue发布了新的文献求助10
7秒前
8秒前
8秒前
木可发布了新的文献求助10
9秒前
9秒前
wyl完成签到,获得积分10
11秒前
汉堡包应助三斤采纳,获得10
12秒前
wangqiuhong发布了新的文献求助10
14秒前
15秒前
失眠的夜梦关注了科研通微信公众号
15秒前
今后应助HIT_C采纳,获得10
16秒前
今后应助SuperZzz采纳,获得10
17秒前
ZONG发布了新的文献求助10
19秒前
Nugget发布了新的文献求助10
20秒前
李茵完成签到,获得积分10
22秒前
量子星尘发布了新的文献求助10
22秒前
汉堡包应助风趣的老太采纳,获得10
23秒前
DongWei95发布了新的文献求助30
25秒前
25秒前
25秒前
猪猪hero发布了新的文献求助10
25秒前
斯文念波发布了新的文献求助10
25秒前
27秒前
29秒前
29秒前
断数循环应助任峰采纳,获得10
30秒前
FIN应助wuyu采纳,获得30
34秒前
越野蟹完成签到 ,获得积分10
34秒前
36秒前
msjs完成签到,获得积分20
36秒前
37秒前
yu发布了新的文献求助10
38秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989406
求助须知:如何正确求助?哪些是违规求助? 3531522
关于积分的说明 11254187
捐赠科研通 3270174
什么是DOI,文献DOI怎么找? 1804901
邀请新用户注册赠送积分活动 882105
科研通“疑难数据库(出版商)”最低求助积分说明 809174