Anthracycline-based therapy of de novo acute myeloid leukemia in adults: Failure of first-cyde cytoreduction to predict second-cycle outcome
Article first published online: 11 JUL 2006
Copyright © 1994 Wiley-Liss, Inc., A Wiley Company
American Journal of Hematology
Volume 47, Issue 3, pages 172–177, November 1994
How to Cite
Hammerschmidt, D. E. and Crea, M. T. W. (1994), Anthracycline-based therapy of de novo acute myeloid leukemia in adults: Failure of first-cyde cytoreduction to predict second-cycle outcome. Am. J. Hematol., 47: 172–177. doi: 10.1002/ajh.2830470305
- Issue published online: 11 JUL 2006
- Article first published online: 11 JUL 2006
- Manuscript Accepted: 11 MAY 1994
- Manuscript Received: 16 FEB 1994
- acute myeloid leukemia;
During 1971–1988, 194 adults with de novo acute myeloid leukemia (AML) received initial therapy at the University of Minnesota with an anthracycline-based regimen. Seventy-two of the 194 required further chemotherapy and received a second cycle of the same or similar therapy; 63 of these 72 were evaluable.
For each marrow, a tumor burden index (TBI) was calculated, as the product of the marrow cellularity and the proportion of malignant cells. For each patient, the decrement in TBI between the initial and day ≈14 marrows was recorded. Patients who achieved second-cycle CR were comparable to those who did not in general descriptors; there was no difference between second-cycle CR achievers and nonachievers in the cytoreduction efleeted by the Initial cycle of therapy (74.9% ± 4.5% [σ] versus 71.9% = 5.9%).
We then stratified patients according to the first-cycle cytoreduction, asking if we could find a level that was reliably predictive of increased or decreased likelihood of achieving CR with cycle 2. We could not, despite testing at many centite cuts. Patients achieving a very “poor” degree of cytoreduction In cycle 1 were as likely to achieve CR with cycle 2 as were patients having a very “good” initial cytoreduction.
We conclude that (1) first-cycle response is not a useful predictor of second-cycle outcome in anthracycline-based therapy of de novo adult AML; and (2) a “poor” response to cycle 1 does not therefore a priori indicate a change to a different regimen for cycle 2. © 1994 Wiley-Liss, Inc.