A Retrospective Study Of Different Dose Idarubicin-based Induction Regimens For Young Patients With De-novo Acute Myeloid Leukemia

Objective:To compare the efficacy and long-term prognosis between different dose Idarubicin-based induction regimens in newly diagnosed patients of acute myeloid leukemia.Methods149newly diagnosed young patients of AML(not include APL) between January2009and July2014were enrolled in our hospital. We retrospectively analyzed the clinical characteristics of the patients,including height and weight..chromosome and so on. Using the NCCN guidelines to evaluate the cytogenetics risk and the comprehensive prognosis risk. According to the dose of Idarubicin(IDA), the patients were divided into three groups, high standard-dose IDA group(10-12mg/m2/d), low standard-dose IDA group(8-9mg/m2/d) and low-dose IDA group(<8mg/m2/d). We compared the efficacy, adverse effects and long-term prognosis between the three groups.Results149newly diagnosed young patients were enrolled,34patients in high standard-dose IDA group,53patients in low standard-dose IDA group and62patients in low-dose IDA group. Low standard-dose IDA and high standard-dose IDA group, as compared with low-dose IDA, resulted in a higher rate of complete remission after one cycle,overall response after one cycle and overall complete remission, especially in the patients with medium cytogenetics risk, NPM1negative-mutation and FLT3-ITD negative-mutation. In logistic analysis, after adjustment for gender, age, and cytogenetic risk, the odds ratio of complete remission for low standard-dose IDA versus low-dose IDA was2.597(95%CI1.010-6.678; p=0.048),the odds ratio of complete remission for low standard-dose IDA versus low-dose IDA was4.721(95%CI1.495-14.906; p=0.008). The adverse effects and early death were similar in the three groups. High-dose IDA can prove the OS compared to the low-dose IDA,but the other outcome(EFS、RFS) was similar in the three groups.ConclusionsFor the newly diagnosed young(<55year older) acute myeloid leukemia patients, the standard-dose Idarubicin-based induction regimens has advantages on complete remission rate compared with decreased-dose, The young AML patients can bear the standard-dose Idarubicin regimen well. The adverse effects were similar in the three groups. High-dose IDA can prove the OS compared to the low-dose IDA,but the other outcome(EFS、RFS) was similar in the three groups.