Total Parenteral Nutrition and Decreased Dose Idarubicin Based Treatment of Acute Myeloid Leukemia During Childhood

Abstract

Aim: Disease free survival rate for acute myeloid leukemia (AML) is still below 50% for the last 30 years. Our objective was to compare the results of two different dosages of idarubicin (12 mg/m2 versus 8 mg/ m2) therapy for newly diagnosed AML patients. Method: Sixty eight patients with AML were treated between February, 1998 and January, 2005. We designed two therapy groups comprising of 12 mg/m2/day idarubicin therapy (group I), 8 mg/m2/ day idarubicin therapy and when oral nutrition is broken, we have given parenteral nutrition (group II). Overall survival (OS), event free survival (EFS), disease free survival (DFS) data were assessed and other tests were performed when needed. Result: There were 26 patients (38.2%) in group I and 42 patients (61.8%) in group II. After the first induction therapy, 20 patients (76.9%) in group I and 36 in group II (85.7%) had CR or partial remission. After two courses of induction, treatment-related mortality (TRM) was 34.6% in group I and 7.1% in group II (p: 0.006). OS of the patients in group I/II were 44/81% for 12 months, 34/54% for 24 months, 29/48% for 36 months. EFS were 43/65% for 12 months, 34/50% for 24 months, and 29/50% for 36 months. OS and DFS rates were statistically significant but EFS rates were not, in group I and II. Conclusion: The protocol with idarubicin dose of 8 mg/m2/day has less TRM in comparison to that of 12 mg/m2/day and has better OS and EFS.