Which Anthracycline for AML Induction Therapy?

Standard induction therapy for acute myeloid leukemia (AML) includes a 7-day infusion of cytarabine plus 3 days of daunorubicin or idarubicin.

Now, Korean investigators have conducted a randomized, unblinded, phase III study of 299 newly diagnosed AML patients (ages, 15–65 years) to compare the use of cytarabine (200 mg/m²) on days 1 through 7 plus either high-dose daunorubicin (90 mg/m²) or standard-dose idarubicin (12 mg/m²) on days 1 through 3. Patients achieving complete remission (CR) could proceed to consolidation chemotherapy or stem-cell transplantation in first CR.

CR rates were similar with daunorubicin or idarubicin (66.7% and 71.1%, respectively), as was 4-year overall survival (OS; 54.7% and 51.1%), although the treatment arms we…