High-dose versus standard-dose daunorubicin in induction therapy for young patients with de novo acute myeloid leukaemia: a meta-analysis of randomised trials. (3rd March 2016)

• Record Type: Journal Article
• Authors: Su, Long; Zhu, Xiaoqing; Gao, Sujun; Li, Wei; Liu, Xiaoliang; Tan, Yehui
• Is Part Of: Journal of chemotherapy. Volume 28:Number 2(2016:Apr.)
• Page Start: 123
• Page End: 128
• Publication Date: 2016-03-03
• Subjects: Acute myeloid leukaemia -- Complete remission rate -- Daunorubicin -- High-dose daunorubicin -- Induction therapy -- Meta-analysis -- Standard-dose daunorubicin; Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1080/1120009X.2015.1133011
• Languages: English
• ISSNs: 1120-009X

Abstract

Abstract : Purpose: To compare the efficacy and safety of high-dose versus standard-dose daunorubicin for young patients with de novo acute myeloid leukaemia (AML) using meta-analysis. Methods: Two trials were taken from 2, 481 full-text articles. Heterogeneity was assessed using the I 2 index. Quality assessment was performed with the Cochrane Collaboration's risk-of-bias tool. Results: The analysis showed that high-dose daunorubicin induction therapy was associated with higher complete remission (CR) rate ( n = 965; RR = 1.80; 95% CI = 1.36–2.38; p < 0.0001; I 2 = 0%) and improved overall survival ( n = 1040; HR = 0.74; 95% CI = 0.63–0.87; p = 0.0003; I 2 = 0%) compared with standard-dose daunorubicin. However, there was no significant interaction between treatment efficacy and prognostic category based on cytogenetics (favourable, intermediate and unfavourable) ( p = 0.44, I 2 = 0%). Conclusion: High-dose daunorubicin therapy could increase CR rate and improve long-term outcome for young patients with de novo AML. However, further study is needed to identify those who can benefit from high-dose daunorubicin.