Seminars in oncology
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Seminars in oncology · Dec 1993
High-dose cytarabine, idarubicin, and granulocyte colony-stimulating factor remission induction therapy for previously untreated de novo and secondary adult acute myeloid leukemia.
This report describes the preliminary results of the remission induction phase of a protocol for previously untreated de novo and secondary acute myeloid leukemia (AML) designed to deliver very intensive therapy over a brief period of time using hematopoietic growth factor support. Remission induction therapy consisted of cytarabine 3 g/m2 (1.5 g/m2 for age > 50 years) intravenously over 1 hour every 12 hours for 12 doses and idarubicin 12 mg/m2 over 30 minutes on days 2, 3, and 4 of cytarabine, followed by 10 micrograms/kg granulocyte colony-stimulating factor subcutaneously daily until the absolute neutrophil count increased to > or = 5.0 x 10(9)/L on 2 consecutive days. Twenty-seven patients received all the planned doses of chemotherapy. ⋯ The use of granulocyte colony-stimulating factor is associated with rapid neutrophil recovery without obvious toxicity. The CR rate for de novo AML patients treated with a single course of high-dose cytarabine, idarubicin, and granulocyte colony-stimulating factor is at least comparable to CR rates achieved with standard-dose cytarabine and anthracycline regimens. The response of secondary AML patients remains inferior.