ROLE OF DAUNORUBICIN IN THE INDUCTION THERAPY FOR ADULT ACUTE MYELOID-LEUKEMIA

Purpose: To evaluate the relationship of total-dose of daunorubicin (D NR) to the induction therapy and treatment outcome, we have administer ed individualized doses of DNR during induction treatment to patients with acute myelogenous leukemia (AML). Patients and Methods: Ninety-tw o previously untreated adult patients with AML who entered our hospi t al were analyzed for the dose of DNR required to achieve complete remi ssion (CR), the CR rate, disease-free survival (DFS), and overall surv ival (OS). induction therapy consisted of DNR 40 mg/m(2) daily intrave nously from day 1 until the marrow was hypoplastic, cytarabine (Ara-C) , prednisolane (PRD), and/or 6-thioguanine (6-TG). Results: Eighty-thr ee of 92 patients with adult AML were assessable for this study. Sixty -three (76%) patients achieved CR. fifty-two of 63 CR patients achieve d the CR in the first course of induction therapy, and 11 patients req uired the second course of induction therapy The 5-year and 10-year DF S rates were 31.2% and 5-year and 10-year OS rates were 45.1% and 42.3 %, respectively. The median total dose of DNR in the induction therapy was 280 mg/m(2) (120 to 480 mg/m(2)). DNR dose did not influence the response to therapy and wets not influenced by the initial WBC count o r French-American British (FAB) system classification. Conclusion: The se results indicated that when the dose was linked to observed tumor r esponse, the optimal dose of DNR in the induction therapy was approxim ately 280 mg/m(2) (40 mg/m(2) for 7 days), which is greater than the c onventional dose of 40 to 60 mg/m(2) for 3 days.