Anthracyclines during induction therapy in acute myeloid leukaemia: a systematic review and meta-analysis.
Br J Haematol
; 161(2): 192-203, 2013 Apr.
Article
em En
| MEDLINE
| ID: mdl-23398482
ABSTRACT
This systematic review and meta-analysis compared the efficacy of different anthracyclines and anthracycline dosing schedules for induction therapy in acute myeloid leukaemia in children and adults younger than 60 years of age. Twenty-nine randomized controlled trials were eligible for inclusion in the review. Idarubicin (IDA), in comparison to daunorubicin (DNR), reduced remission failure rates (risk ratio (RR) 0·81; 95% confidence interval (CI), 0·66-0·99; P = 0·04), but did not alter rates of early death or overall mortality. Superiority of IDA for remission induction was limited to studies with a DNR/IDA dose ratio <5 (ratio <5 RR 0·65; 95% CI, 0·51-0·81; P < 0·001; ratio ≥5 RR 1·03; 95% CI, 0·91-1·16; P = 0·63). Higher-dose DNR, compared to lower-dose DNR, was associated with reduced rates for remission failure (RR 0·75; 95% CI, 0·60-0·94; P = 0·003) and overall mortality (RR 0·83; 95% CI, 0·75-0·93; P < 0·001), but not for early death. Comparisons of several other anthracycline derivates did not reveal significant differences in outcomes. Survival estimates in adults suggest that both high-dose DNR (90 mg/m(2) daily × 3 or 50 mg/m(2) daily × 5) and IDA (12 mg/m(2) daily × 3) can achieve 5-year survival rates of between 40 and 50 percent.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Idarubicina
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Leucemia Mieloide Aguda
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Daunorrubicina
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Antibióticos Antineoplásicos
Tipo de estudo:
Clinical_trials
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Systematic_reviews
Limite:
Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
Idioma:
En
Revista:
Br J Haematol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Suíça