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Consolidation Treatment in AML: Comparing Intermediate and High Dosing of Cytarabine

By: Justine Landin, PhD
Posted: Wednesday, June 23, 2021

Intermediate-dose cytarabine (IDAC) as consolidation chemotherapy may be as efficacious for the treatment of acute myeloid leukemia (AML) as high-dose cytarabine (HiDAC), according to researchers from Chiang Mai University Hospital, Thailand. The 1-year relapse-free and overall survival rates seemingly did not differ between the intermediate and high dosing therapies in this patient population. This retrospective study was published in the journal Hematology.

“This study supports the IDAC regimen as an acceptable option for consolidation treatment in AML,” stated Lalita Norasetthada, MD, and colleagues.

Patients with AML who had received continuous intravenous infusions of cytarabine for 7 days and anthracycline for 3 days were enrolled in the study. Those who achieved complete remission following one to two cycles of induction (n = 32) received HiDAC consolidation therapy (3 g/m2 every 12 hours, days 1, 3, and 5). Patients diagnosed with AML after January 2017 (n = 30) received IDAC therapy (1.5 g/m2 every 12 hours, days 1 ,3, and 5). The majority of patients underwent three to four cycles of consolidation therapy.

The 1-year relapse-free survival rates were not significantly different when comparing patients with AML who received IDAC (37.5%) or HiDAC consolidation therapy (55.6%, P = .18). However, patients who received three to four cycles of IDAC reportedly had a relapse-free survival doubled that with four cycles of HiDAC (70.5%–73.6% vs. 37.5%). For patients who received IDAC, the 1-year overall survival rates did not differ compared with those for the group given HiDAC (P = .69). After 2 years, the incidence of relapse was 75% in the HiDAC group compared with 43% in the IDAC group (P = .01). There appeared to be no differences in hematologic adverse advents between groups, although the duration of grade 3 to 4 thrombocytopenia was lower following IDAC (P = .04).

Disclosure: The study authors reported no conflicts of interest.


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