DAC and CLAM are equally effective as early second induction in newly diagnosed AML patients with persistent leukemia in early bone marrow evaluation – a retrospective analysis of Polish Adult Leukemia Group
Abstract
This study presents a retrospective analysis of patients with acute myeloid leukemia < 60 years of age, who had ≥10% blasts in early bone marrow evaluation on day 14 of their first DAC (daunorubicin + AraC + cladribine) induction cycle. Patients included in this analysis were treated according to the PALG-AML-1/2012 and PALG AML-1/2016 studies. As the second early induction, 22 patients received DAC and 35 patients received CLAM (cladribine + AraC + mitoxantrone). There was no significant difference between patients treated with CLAM and those treated with DAC chemotherapy in terms of overall survival (OS after 2 years 52% vs. 76% for DAC, HR 0.68, 95% CI: 0.26–1.77, p = 0.4). Furthermore, there was no significant difference in composite complete remission (cCR) rates between the two treatment regimens: 60% (21/35) for CLAM and 54.6% (12/22) for DAC (p > 0.05). Both treatment regimens had a similar toxicity profile and early death rate.
Keywords: refractory acute myeloid leukemiaearly second inductiontreatmentcladribine