Journal
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
Volume 27, Issue 3-4, Pages 259-264Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.beha.2014.10.007
Keywords
acute myeloid leukemia; AML; cytarabine; ara-C; high-dose; intermediate-dose
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Approximately 35%-40% of younger adults with acute myeloid leukemia (AML) can be cured using higher doses of cytosine arabinoside (ara-C) as post remission consolidation. Earlier studies focused on higher doses of 3 gms/m(2), but since then numerous studies evaluating differences in dose, schedule, number of courses, and the addition of other agents, suggest that an intermediate-dose of ara-C may offer the greatest benefit to most patients with less toxicity than with higher dose regimens. In retrospect, this was predictable by the cellular pharmacology of ara-C. Perhaps most importantly, the overall outcome has not changed in the past 2-3 decades, indicating that the limits of available chemotherapy have been defined for AML This review examines studies that have established the various dosing options and considers whether there is a true standard for post remission therapy for patients with AML. (C) 2014 Elsevier Ltd. All rights reserved.
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