Anthracyclines during induction therapy in acute myeloid leukaemia: a systematic review and meta-analysis

Teuffel, Oliver; Leibundgut, Kurt; Lehrnbecher, Thomas; Alonzo, Todd A; Beyene, Joseph; Sung, Lillian (2013). Anthracyclines during induction therapy in acute myeloid leukaemia: a systematic review and meta-analysis. British journal of haematology, 161(2), pp. 192-203. Oxford: Wiley-Blackwell 10.1111/bjh.12233

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This systematic review and meta-analysis compared the efficacy of different anthracyclines and anthracycline dosing schedules for induction therapy in acute myeloid leukaemia in children and adults younger than 60 years of age. Twenty-nine randomized controlled trials were eligible for inclusion in the review. Idarubicin (IDA), in comparison to daunorubicin (DNR), reduced remission failure rates (risk ratio (RR) 0·81; 95% confidence interval (CI), 0·66-0·99; P = 0·04), but did not alter rates of early death or overall mortality. Superiority of IDA for remission induction was limited to studies with a DNR/IDA dose ratio <5 (ratio <5: RR 0·65; 95% CI, 0·51-0·81; P < 0·001; ratio ≥5: RR 1·03; 95% CI, 0·91-1·16; P = 0·63). Higher-dose DNR, compared to lower-dose DNR, was associated with reduced rates for remission failure (RR 0·75; 95% CI, 0·60-0·94; P = 0·003) and overall mortality (RR 0·83; 95% CI, 0·75-0·93; P < 0·001), but not for early death. Comparisons of several other anthracycline derivates did not reveal significant differences in outcomes. Survival estimates in adults suggest that both high-dose DNR (90 mg/m(2) daily × 3 or 50 mg/m(2) daily × 5) and IDA (12 mg/m(2) daily × 3) can achieve 5-year survival rates of between 40 and 50 percent.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Teuffel, Marc Oliver, Leibundgut, Kurt

ISSN:

0007-1048

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

04 Oct 2013 14:41

Last Modified:

05 Dec 2022 14:12

Publisher DOI:

10.1111/bjh.12233

PubMed ID:

23398482

Web of Science ID:

000317124200007

URI:

https://boris.unibe.ch/id/eprint/16545 (FactScience: 224200)

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