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High Dose Daunorubicin in Acute Myeloid Leukemia
Studying possible benefits
Benefit of high dose (HD) daunorubicin was seen in a subgroup of patients with acute myeloid leukemia (AML) aged 50 to 60 years and with FLT3-ITD or NPM1 mutation. This according to a study of patients with AML in the ECOG-ACRIN Cancer Research Group trial E1900. Researchers found:
- Compared to standard dose daunorubicin (45 mg/m2), HD daunorubicin (90 mg/m2) is associated with a hazard ratio (HR) for death of 0.74.
- Patients aged <50 years benefited from HD daunorubicin (HR=0.66), as did patients with favorable (HR=0.51) and intermediate (HR=0.68) cytogenetics.
- Patients with unfavorable cytogenetics were shown to benefit from HD daunorubicin on multivariable analysis (aHR=0.66).
- Patients with FLT3-ITD (HR=0.61), DNMT3A (HR=0.62), and NPM1 (HR=0.50) mutant AML all benefited from HD daunorubicin.
Citation: Luskin MR, Lee JW, Fernandez HF, et al. Benefit of high dose daunorubicin in AML induction extends across cytogenetic and molecular groups: updated analysis of E1900. [Published online ahead of print January 11, 2016]. Blood. doi: 10.1182/blood-2015-07-657403.