Comparison of 60 and 80mg/m super(2) of daunorubicin in induction therapy of acute myeloid leukaemia

For finding better method of acute myeloid leukaemia (AML) induction, we designed a prospective clinical trial to find a more effective regimen with least toxicity for induction therapy of AML. Hence, we examined different accepted doses of daunorubicin and their outcomes. Total of 114 patients were included in the study. Fifty-five patients received 60mg/m super(2) of daunorubicin (arm 1) 1h IV infusion for 3days, and the remaining 59 received 80mg/m super(2) (arm 2) 1h IV infusion for 3days. Continuous infusion of 100mg/m super(2)/day of cytosine arabinozide IV for 24h for 7days was given in both groups. Complete remission rate was 77.78% in group 1 and 76.92% in group 2 (p=0.92). One-year overall survival was 55.85% [standard error (SE)=8.05%] in arm 1 and 57.94% (SE=7.32%) in arm 2. Median follow-up time was 11.1 (SE=1.43) and 10.28 (SE=1.29)months, respectively. One-year disease-free survival was 64.41% (SE=7.39%) in arm 1 and 54.86% (SE=7.53%) in arm 2. Complete remission, overall survival and disease-free survival were statistically the same in both groups (p=0.92, 0.697, 0.31). Toxicity and safety profile were similar in two groups but need to transfusion was higher in arm 2. Febrile neutropenia, days of antibiotics consumption and invasive fungal infection prevalence did not show any difference. Mean transfused packed cells and platelets rate were higher in the group that received higher dose of daunorubicin. Considering these results, we found that 60mg/m super(2) of daunorubicin would be more rational and as effective with lower toxicity to 80mg/m super(2) in induction therapy of AML patients at least as scheduled in our trial.