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In the March issue of Leukemia Research, Eun-Ji Choi from Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea, and colleagues published results of their retrospective analysis examining the clinical impact of different types and doses of anthracyclines as a part of induction regimen for the treatment of newly diagnosed FLT3-ITD mutated acute myeloid leukemia (AML) patients. Study endpoints included the response to induction treatment, relapse, and survival rates.
In total, 128 adult patients with AML harboring FLT3-ITD mutations who received one of three induction regimens at the Asan Medical Center between January 2002 and September 2016 were included in this analysis. Patients were administered induction regimens consisting of either high-dose daunorubicin (HD-DN; 90 mg/m2/d for 3 days, n = 44), standard-dose daunorubicin (SD-DN; 45 mg/m2/d for 3 days; n = 51), or idarubicin (IDA; 12 mg/ m2/d for 3 days; n = 33) in combination with cytarabine (100 or 200 mg/m2/d for 7 days).
In summary, compared with SD-DN, HD-DN improved CR, OS, and EFS in FLT3-ITD-mutated AML patients. In vitro examination of FLT3-ITD-mutated cell lines confirmed these findings. Moreover, HD-DN showed superior outcomes than IDA, nevertheless the difference was not significantly different. The study group further added that “optimal combinations of FLT3 inhibitors and effective intensive chemotherapy regimens should be defined.” The advantage of HD-DN versus IDA requires further investigation.
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