Abstract
Purpose: To compare the efficacy and safety of high-dose versus standard-dose daunorubicin for young patients with de novo acute myeloid leukaemia (AML) using meta-analysis.Methods: Two trials were taken from 2,481 full-text articles. Heterogeneity was assessed using the I2 index. Quality assessment was performed with the Cochrane Collaboration’s risk-of-bias tool.Results: The analysis showed that high-dose daunorubicin induction therapy was associated with higher complete remission (CR) rate (n = 965; RR = 1.80; 95% CI = 1.36–2.38; p < 0.0001; I2 = 0%) and improved overall survival (n = 1040; HR = 0.74; 95% CI = 0.63–0.87; p = 0.0003; I2 = 0%) compared with standard-dose daunorubicin. However, there was no significant interaction between treatment efficacy and prognostic category based on cytogenetics (favourable, intermediate and unfavourable) (p = 0.44, I2 = 0%).Conclusion: High-dose daunorubicin therapy could increase CR rate and improve long-term outcome for young patients with de novo AML. However, further study is needed to identify those who can benefit from high-dose daunorubicin.
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