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) - Su, Long
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.