Cytarabine Dosing for Acute Myeloid Leukemia: Less Is More

Induction chemotherapy with intermediate-dose cytarabine provided equivalent responses and less toxicity compared with a high-dose regimen.

The use of cytarabine-based regimens during induction and consolidation therapy for acute myeloid leukemia (AML) is an accepted standard of care. To determine whether lowering the standard dose of cytarabine would provide equivalent efficacy with less toxicity, European investigators conducted a multicenter, randomized trial of standard, high-dose (HD) cytarabine versus intermediate-dose (ID) cytarabine in 860 patients with newly diagnosed AML or myelodysplastic syndrome (MDS) and excess blasts.

Patients in the HD group received 1000 mg/m² of cytarabine (twice daily for 5 days) during induction cycle 1 followed by 2000 mg/m² of cytarabine (twice daily on days 1, 2, 4, and 6) during cycle 2. Patients in the ID group received 200 mg/m² of cyta…

Reviewing Author

Michael E. Williams, MD

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee

Michael E. Williams, MD

Disclosures

Consultant/Advisory BoardAbbVie; AstraZeneca; Beigene; Janssen; Pharmacyclics

Grant/Research SupportJanssen

Editorial BoardsAmerican Board of Internal Medicine (ABIM) Hematology Longitudinal Knowledge Approval Committee