Remission induction with cytarabine and daunorubicin with or without 6-thioguanine in adult patients with acute myelocytic leukemia.

Abstract

Cytosine arabinoside (Ara-C) and daunorubicin (DNR) are the two most active agents in the treatment of acute myelocytic leukemia (AML) with complete remission (CR) rates of 20%–30% and 33%–55%, respectively [1]. Combinations of the two drugs given in their optimal schedules have shown CR rates of 55%–66% in patients with AML [2, 3]. In contrast to Ara-C and DNR, 6-thioguanine (6-TG) is known to be only marginally active against AML when given as a single agent [1]. On the other hand, CR rates of up to 76% have been achieved using combinations of Ara-C and DNR together with 6-TG [4]. However, there are only a few direct comparative studies concerning the effect of 6-TG on the efficacy of Ara-C and DNR in AML [5, 6]. In these studies, the drugs were given in suboptimal schedules resulting in relatively low CR rates in regimens with or without 6-TG. The present report deals with the clinical results in 116 adult patients with AML who were treated for remission induction (RI) either with a combination of Ara-C and DNR or an intensified combination of these two drugs together with 6-TG. The patients were treated in a single institution under comparable routine supportive care.