Efficacy of Low Dose Doxorubicin Therapy in Patients with Non-APL Acute Myeloblastic Leukemia

Abstract

Background: Doxorubicin is a chemotherapeutic drug that acts by blocking topoisomerase 2 enzyme. It is used for treatment of many solid and hematological cancers; unfortunately it has serious side effects. The usual Doxorubicin dose for patients with acute myeloblastic leukemia (AML) is 40-60 mg/m2. This is the first study that assessed the efficacy of low dose Doxorubicin in patients with non acute promyelocytic leukemia (APL) AML. Methods: A retrospective study was done at Assiut University, where data were collected from hospital records of 103 patients with AML, after fulfilling certain inclusion criteria. Patients were treated with the conventional 3/7 induction regimen, however doxorubicin was prescribed in a lower dose compared with other studies. Results: The median age of our patients was 38 years, and 86.4% were with primary AML. Complete remission (CR) was achieved in 60.2% of the study patients. Primary AML type and M2 FAB subtype, were found to be good prognostic factors (P=0.000 and 0.067, respectively). Survival analysis showed that the longest overall survival (OS) and disease free survival (DFS) for the study patients were 60 and 55 months respectively. There was no significant difference regarding OS and DFS between male and female patients (P=0.903, 0.848, respectively). Conclusion: In conclusion this study provided a novel therapeutic strategy that encourages the use of low dose Doxorubicin for treatment of young age adults with non- APL AML. This will reduce treatment expenses, minimize cardiotoxicity, and allow addition of adjunctive therapy which in its turn minimizes resistance.