Impact of dose-intensified daunorubicin in induction on patients with core binding factor acute myeloid leukemias

Abstract

6712 Background: The group of core binding factor (CBF) acute myeloid leukemias (AML) is defined by presence of the t(8;21) or the inv(16) and there is major agreement that high-dose Ara-C (HiDAC) may influence the outcome of those patients. In our institution, we tried two consecutive AML treatment trials including dose-intensified daunorubicin (DNR) in induction comparing to conventional treatments and without HiDAC based consolidation. Purpose: To investigate the impact of dose-intensified DNR in induction on patients with CBF AML, we retrospectively analyzed patients with AML who were treated by DC(T)P(III) or Double-7 therapy which were conducted in our institution from February 1985 and October 2001. Results: Twenty-four of 117 patients (median age, 45 y.o.; range, 17 to 63 y.o.; median PS, 1; range, 0 to 3; male: female, 15: 9) were identified CBF AML and they were assessable for this study. The median dose of DNR in induction was 280 (range, 200 to 400) mg/m2. Four patients underwent autologous PBSCT whose conditioning regimen included HiDAC after consolidation. The t(8;21) were identified in 18 patients (alone: 4, others: 14) and the inv(16) were in 6 patients (alone: 2, others: 4). Twenty-two (91.7%) patients achieved CR (t(8;21): 88.9%, inv(16): 100%). The 5-year disease-free survival and overall survival rates were 49.5% (t(8;21): 51.9%, inv(16): 41.7%) and 60.1% (t(8;21): 58.2%, inv(16): 66.7%). Six of 11 patients who relapsed or failed to the initial therapy received salvage therapy including HiDAC, but no one survived at the time when this data was calculated in those patients. Conclusions: The role of DNR or other anthracyclines for patients with CBF AML might be investigated as well as that of HiDAC. No significant financial relationships to disclose.