Randomized comparison of double induction and timed-sequential induction to a "3 + 7" induction in adults with AML: long-term analysis of the Acute Leukemia French Association (ALFA) 9000 study.

Abstract:

:Between 1990 and 1996, we conducted a randomized trial in adults with newly diagnosed acute myeloid leukemia (AML) in order to compare relapse-free interval (RFI) after double induction (arm B), timed-sequential induction (arm C), or control "3 + 7" induction (arm A). Patients achieving complete remission (CR) after induction +/- salvage received the same consolidation chemotherapy, which included a dosage stratification according to patient's age (younger or older than 50 years). This long-term analysis was performed in 592 patients (arm A/B/C, 197/198/197 patients). Overall CR rate was 76% without differences between the 3 arms, even if a salvage course was less frequently needed in arm B. Treatment-related mortality, either during the induction or the postremission phase, was not significantly higher in arms B and C than in arm A. Among the 449 CR patients, 250 relapsed (arm A/B/C, 90/87/73 patients) without significant differences in RFI in arms B and C versus arm A (P = .39 and .15, by the Gray test). However, when analyzing the 345 patients younger than 50, RFI was significantly improved in younger patients receiving timed-sequential induction (P = .038 by the Gray test), while not in those receiving double induction. Event-free survival and overall survival were similar in the 3 randomization arms.

journal_name

Blood

journal_title

Blood

authors

Castaigne S,Chevret S,Archimbaud E,Fenaux P,Bordessoule D,Tilly H,de Revel T,Simon M,Dupriez B,Renoux M,Janvier M,Micléa JM,Thomas X,Bastard C,Preudhomme C,Bauters F,Degos L,Dombret H

doi

10.1182/blood-2003-10-3561

subject

Has Abstract

pub_date

2004-10-15 00:00:00

pages

2467-74

issue

8

eissn

0006-4971

issn

1528-0020

pii

2003-10-3561

journal_volume

104

pub_type

临床试验,杂志文章,随机对照试验

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