Comparison between Daunorubicin and Idarubicin in Acute Myelocytic Leukemia Induction Therapy and the Analysis of Prognostic Factors / 대한혈액학회지

ABSTRACT

BACKGROUND: Anthracycline is the most important chemotherapy drug of acute myelocytic leukemia (AML). It has been reported that idarubicin could have better complete remission (CR) rate than daunorubicin. However, it is not completely established concerning the effectiveness of idarubicin. There are many prognostic indicators of AML, however, many discrepancies still exist in prognostic indicators among each centers. METHODS: We analyzed initial CR rate of 39 AML patients treated with combination of cytarabine plus idarubicin or daunorubicin at Samsung Medical Center from April, 1995 to December, 1997. We subgrouped the patients according to age, sex, initial WBC count, status of initial CR, CD34, and chromosome. We analyzed the initial CR rate and long term survival of each subgroups. RESULTS: Initial CR rates of idarubicin and daunorubicin were 76.5% and 72.7%, respectively. The median survival days of 39 patients was 727+/-308.8 days. 1-year survival rate and 1-year event free survival rate were 64.2% and 59.6%, respectively. Patients who had failure of initial CR, old age (>60 years), and initial high WBC counts (>100,000/L) showed a statistically significant shorter survival in univariate analysis. However, we could not find the significant difference in the positivity of CD34 and chromosomal abnormalities. CONCLUSION: The effectiveness of idarubicin may be equivalent to that of daunorubicin. Failure of initial CR, old age, and high WBC counts were regarded as a prognostic risk factors of AML. However, a more definitive characterization of prognostic factors is warranted in further prospective study.