课件：急性髓系白血病(非APL)治疗的流程图.ppt

* * * * * * DFS and OS by treatment arm for the intermediate cytogenetic risk group. (A) Predicted 5-year DFS was 38% for the HiDAC group (n = 242; red line) and 39% for the multiagent CT group (n = 256; blue line; P = .403). (B) Predicted 5-year OS was 53% for the HiDAC group (n = 242; red line) and 54% for the multiagent CT group (n = 256; blue line; P = .482). * * * Black rectangles indicate summary effects estimates (hazard ratios [HRs]) for individual study reports. Sizes of data markers are proportional to the study weights. Error bars indicate 95% confidence intervals (CIs). AML indicates acute myeloid leukemia; RFS, relapse-free survival. aStudies only reporting RFS end points. * Black rectangles indicate summary effects estimates (hazard ratios [HRs]) for individual study reports. Sizes of data markers are proportional to the study weights. Error bars indicate 95% confidence intervals (CIs). AML indicates acute myeloid leukemia. * Background A complete remission is essential for prolonging survival in patients with acute myeloid leukemia (AML). Daunorubicin is a cornerstone of the induction regimen, but the opt imal dose is unknown. In older pat ients, it is usual to give daunorubicin at a dose of 45 to 50 mg per square meter of body-surface area. Methods Patients in whom AML or high-risk refractory anemia had been newly diagnosed and who were 60 to 83 years of age (median, 67) were randomly assigned to receive cytara- bine, at a dose of 200 mg per square meter by continuous infusion for 7 days, plus daunorubicin for 3 days, either at the conventional dose of 45 mg per square meter (411 patients) or at an escalated dose of 90 mg per square meter (402 patients); this treatment was followed by a second cycle of cytarabine at a dose of 1000 mg per square meter every 12 hours for 6 days. The primary end point was event-free survival. Results The complete remission rates were 64% in the group that received the escalated dose of daunorubici