Sequential multiagent chemotherapy is not superior to high-dose cytarabine alone as postremission intensification therapy for acute myeloid leukemia in adults under 60 years of age: Cancer and Leukemia Group B Study 9222
Sequential multiagent chemotherapy is not superior to high-dose cytarabine alone as postremission intensification therapy for acute myeloid leukemia in adults under 60 years of age: Cancer and Leukemia Group B Study 9222
复制标题
DOI：
10.1182/blood-2004-08-2977
复制
发表时间：
2005-05-01
期刊：
影响因子：
20.3
通讯作者：
Schiffer, CA
中科院分区：
文献类型：
--
作者：
Moore, JO;George, SL;Schiffer, CA
癌症和白血病B组（CALGB）研究9222验证了急性髓系白血病（AML）首次缓解时使用多种化疗药物的治疗强化优于单独使用高剂量阿糖胞苷（HiDAC）的假设。我们招募了474名年龄小于60岁的未经治疗的新生AML患者。柔红霉素和阿糖胞苷在342例（72%）患者中导致完全缓解（CR），其中309例患者随机接受2种不同强化方案中的一种。第一方案由3个疗程的HiDAC组成。第二个方案包括一个疗程的HiDAC，第二个疗程的依托泊苷和环磷酰胺，第三个疗程的重氮喹酮和米托蒽醌。中位随访时间为8.3年，所有随机患者的中位生存期为2.8年（95% CI, 1.9-6.8年）。两种治疗方案的无病生存期（DFS）无差异（P = 0.66）。接受HiDAC的患者的中位DFS为1.1年（95% CI, 0.9-1.7年），接受多药化疗的患者的中位DFS为1.0年（95% CI, 0.9-1.3年）。细胞遗传学是DIFS唯一的预处理特征预后，但没有证据表明在细胞遗传学风险组中有不同的治疗效果。多药化疗的毒性更大。这两种缓解后方案产生了相似的结果。(c) 2005年由美国血液学会出版。
The Cancer and Leukemia Group B (CALGB) study 9222 tested the hypothesis that treatment intensification of acute myeloid leukemia (AML) in first remission with multiple chemotherapy agents is superior to high-dose cytarabine (HiDAC) alone. We enrolled 474 patients younger than 60 years old with untreated de novo AML. Daunorubicin and cytarabine resulted in complete remission (CR) in 342 patients (72%), and 309 of these patients were randomized to receive one of 2 different intensification regimens. The first regimen consisted of 3 courses of HiDAC. The second regimen consisted of one course of HiDAC, a second course with etoposide and cyclophosphamide, and a third course with diaziquone and mitoxantrone. After a median follow-up time of 8.3 years, the median survival for all randomized patients was 2.8 years (95% CI, 1.9-6.8 years). There was no difference in disease-free survival (DFS) between the 2 regimens (P = .66). The median DFS was 1.1 years (95% CI, 0.9-1.7 years) for patients receiving HiDAC and 1.0 year (95% CI, 0.9-1.3 years) for those receiving multiagent chemotherapy. Cytogenetics Was the only pretreatment characteristic prognostic for DIFS, but there was no evidence of a differential treatment effect within cytogenetic risk groups. Toxicity was greater with multiagent chemotherapy. These 2 postremission regimens produced similar outcomes. (c) 2005 by The American Society of Hematology.