WHAT IS THE BEST INDUCTION REGIMEN FOR ACUTE MYELOGENOUS LEUKEMIA

The pursuit of the best induction regimen for acute myelogenous leukem ia (AML) continues in an attempt to Improve complete response rates an d long-term disease free and overall survival. At this time, standard induction therapy generally consists of an anthracycline, most commonl y daunorubicin given at a dose of 45-60 mg/m(2) intravenously for 3 da ys and cytarabine arabinoside (ara-c) given at a dose of 100-200 mg/m( 2) intravenously by continuous infusion for 7 days. This regimen is ba sed on findings from classic studies conducted from the late 1960s thr ough the 1980s. Research on intensifying induction therapy has continu ed over the past decade. potential strategies for Intensifying inducti on therapy Include (1) modulation of the anthracycline dose or agent; (2) modulation of ara-C; (3) the addition of other agents to standard induction therapy; (4) timed-sequential therapy; and (5) very early in tensification therapy. Accurate interpretation of results from studies of intensifying induction therapy requires consideration of variables such as patient age, study inclusion criteria (eg, antecedent myelody splasia), supportive care and, most importantly, patient selection. Fu rthermore, any benefit in long-term outcome during induction cannot be determined without regard to the choice of postremission therapy.