作者: Nélson Alexandre Kretzmann ; Juliana Tieppo ; Luiz Alberto Forgiarini Junior ; Norma Anair Possa Marroni ; Alexandre Simões Dias ; Jaqueline Nascimento Picada

2010-02-10·Journal of Clinical Oncology1区 · 医学

Randomized Study of Intensified Anthracycline Doses for Induction and Recombinant Interleukin-2 for Maintenance in Patients With Acute Myeloid Leukemia Age 50 to 70 Years: Results of the ALFA-9801 Study

1区 · 医学

Article

作者: Turlure, Pascal ; Raffoux, Emmanuel ; de Revel, Thierry ; Contentin, Nathalie ; Dombret, Hervé ; Castaigne, Sylvie ; Chevret, Sylvie ; Bordessoule, Dominique ; Fenaux, Pierre ; Michallet, Mauricette ; Terré, Christine ; Preudhomme, Claude ; Bourhis, Jean-Henri ; Rousselot, Philippe ; Thomas, Xavier ; Pautas, Cecile ; Reman, Oumedaly ; Corm, Selim ; Merabet, Fatiha ; Gardin, Claude

Purpose In patients with acute myeloid leukemia (AML), induction chemotherapy is based on standard doses of anthracyclines and cytarabine. High doses of cytarabine have been reported as being too toxic for patients older than age 50 years, but few studies have evaluated intensified doses of anthracyclines. Patients and Methods In this randomized Acute Leukemia French Association 9801 (ALFA-9801) study, high doses of daunorubicin (DNR; 80 mg/m2/d × 3 days) or idarubicin (IDA4; 12 mg/m2/d × 4 days) were compared with standard doses of idarubicin (IDA3; 12 mg/m2/d × 3 days) for remission induction in patients age 50 to 70 years, with an event-free survival (EFS) end point. After two consolidation courses based on intermediate doses of cytarabine, patients in continuous remission were randomly assigned to receive or not receive maintenance therapy with recombinant interleukin-2 (rIL-2; 5 × 106 U/m2 × 5 days each month) for a total duration of 12 months. A total of 468 patients entered the study (median age, 60 years). Results Overall complete remission rate was 77% with significant differences among the three randomization arms (83%, 78%, and 70% in the IDA3, IDA4, and DNR arms, respectively; P = .04). However, no significant differences were observed in relapse incidence, EFS, or overall survival among the three arms. In the 161 patients randomly assigned for maintenance therapy, no difference in outcome was observed between the rIL-2 and the no further treatment arms. Conclusion Neither intensification of anthracycline doses nor maintenance with rIL-2 showed a significant impact on AML course, at least as scheduled in this trial.

2005-01-20·Journal of Clinical Oncology1区 · 医学

Advanced-Stage Large-Cell Lymphoma in Children and Adolescents: Results of a Randomized Trial Incorporating Intermediate-Dose Methotrexate and High-Dose Cytarabine in the Maintenance Phase of the APO Regimen: A Pediatric Oncology Group Phase III Trial

1区 · 医学

Article

作者: Hutchison, Robert E. ; Kepner, James ; Schwenn, Molly ; Chang, Myron ; Laver, Joseph H. ; Weinstein, Howard J. ; Weitzman, Sheila ; Desai, Sunil ; Tarbell, Nancy ; Murphy, Sharon B. ; Kraveka, Jacqueline M.

Purpose The Pediatric Oncology Group adopted a histology-based approach to non-Hodgkin's lymphoma and treated patients with advanced large-cell lymphoma on a separate protocol (doxorubicin, vincristine, prednisone, 6-mercaptopurin, and methotrexate; APO regimen). In this study, we assessed the effects of an intense antimetabolite therapy alternating with APO on overall survival (OS) and event-free survival (EFS) and looked into biologic correlates. Patients and Methods From December 1994 to April 2000, we enrolled 180 eligible pediatric patients with stage III/IV large-cell lymphoma (LCL); 90 patients were randomly assigned to the intermediate-dose methotrexate (IDM) and high-dose cytarabine (HiDAC) arm, 85 patients to the APO arm, and five patients directly to the APO arm by study design due to CNS involvement. Planned therapy duration was 12 months. Results The 4-year EFS for all patients was 67.4% (SE, 4.2%), and OS was 80.1% (SE, 3.6%) without any significant difference between the two arms. The 4-year EFS and OS were 71.8% (SE, 6.1%) and 88.1% (SE, 4.4%), respectively, for patients with anaplastic large-cell lymphoma, and 63.8% (SE, 10.3%) and 70.3% (SE, 9.0%), respectively, for patients with diffuse large B-cell lymphoma. Only 11 patients required radiation (due to unresponsive bulky disease or CNS involvement). The IDM/HiDAC arm was associated with more toxicity. Conclusion The efficacy of incorporating IDM/HiDAC in the treatment plan of pediatric and adolescent patients with advanced-stage LCL was inconclusive as to its effect on EFS, regardless of the lymphoma phenotype. It cannot be excluded that with a higher number of patients, one treatment could prove superior and future studies will build on these data.

100 项与 IDA-4 相关的药物交易

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