Vol 55, No 5 (2024)
Original research article
Published online: 2024-09-30

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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

Kamil Brzozowski12, Agnieszka Pluta12, Martyna Włodarczyk3, Grzegorz Helbig3, Małgorzata Raźny4, Tomasz Gromek5, Marek Hus5, Marta Sobas6, Łukasz Bołkun7, Elżbieta Patkowska8, Andrzej Szczepaniak9, Krzysztof Gawroński10, Janusz Hałka11, Edyta Cichocka12, Elżbieta Wiater13, Agata Obara14, Ewa Wawrzyniak115, Agnieszka Wierzbowska12
Acta Haematol Pol 2024;55(5):245-251.

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.