急性髓系白血病非APL治疗的流程图__培训课件.ppt

* We conducted a multi-institutional ran- domized study to determinewhether high- dose daunorubicin would be as effective as standard-dose idarubicin in remission- induction therapy for newly diagnosed adult patients younger than 65 years of age with acute myeloid leukemia. Of 1064 patients registered, 1057 were evaluable. They were randomly assigned to receive either daunorubicin (50 mg/m2 daily for 5 days) or idarubicin (12 mg/m2 daily for 3 days) in combination with 100 mg/m2 of cytarabine by continuous infusion daily for 7 days as induction ther- apy. Complete remission was achieved in 407 (77.5%) of 525 patients in the daunorubicin group and 416 (78.2%) of 532 in the idarubicin group (P
.79). Pa- tients achieving complete remission re- ceived intensive postremission therapy that consisted of either 3 courses of high- dose cytarabine or 4 courses of standard- dose therapy. Overall survival rates at 5 years were 48% for the daunorubicin group and 48% for the idarubicin group (P
.54), and relapse-free survival rates at 5 years were 41% and 41% (P
.97), respectively. Thus, high-dose dauno- rubicin and standard-dose idarubicin were equally effective for the treatment of adult acute myeloid leukemia, achieving a high rate of complete remission and good long-term ef?cacy. This study is registered at http://www.umin.ac.jp/ctrj/ as C000000157. (Blood. 2011;117(8): 2358-2365) * * * * * * DFS and OS by treatment arm for the intermediate cytogenetic risk group. (A) Predicted 5-year DFS was 38% for the HiDAC group (n = 242; red line) and 39% for the multiagent CT group (n = 256; blue line; P = .403). (B) Predicted 5-year OS was 53% for the HiDAC group (n = 242; red line) and 54% for the multiagent CT group (n = 256; blue line; P = .482). * * * Black rectangles indicate summary effects estimates (hazard ratios [HRs]) for individual study reports. Sizes of data markers are proportional to the study weights. Error bars indicate 95% confidence intervals (CIs). AML indicat