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Prepublished online as a Blood First Edition Paper on August 1, 2002; DOI 10.1182/blood-2001-12-0354. This Article Full Text Full Text (PDF) All Versions of this Article: 2001-12-0354v1 100/12/3869    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Anderson, J. E. Articles by Appelbaum, F. R. Search for Related Content PubMed PubMed Citation Articles by Anderson, J. E. Articles by Appelbaum, F. R. Related Collections Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 December 2002, Vol. 100, No. 12, pp. 3869-3876 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Outcome after induction chemotherapy for older patients with acute myeloid leukemia is not improved with mitoxantrone and etoposide compared to cytarabine and daunorubicin: a Southwest Oncology Group study Jeanne E. Anderson, Kenneth J. Kopecky, Cheryl L. Willman, David Head, Margaret R. O'Donnell, Frederick W. Luthardt, Thomas H. Norwood, I-Ming Chen, Stanley P. Balcerzak, David B. Johnson, and Frederick R. Appelbaum From the Katmai Oncology Group, Anchorage, AK; Southwest Oncology Group Statistical Center and the Puget Sound Oncology Consortium, Seattle, WA; University of New Mexico, Albuquerque; Vanderbilt University Medical Center, Nashville, TN; City of Hope National Medical Center, Duarte, CA; Ohio State University Health Center, Columbus, OH; and Wichita Community Clinical Oncology Program, KS. Complete remission and long-term survival rates are low for older adults treated for acute myeloid leukemia (AML). Because of favorable phase 2 data using mitoxantrone and etoposide, we conducted a phase 3 study (SWOG-9333) in which patients over 55 years of age with previously untreated AML were randomized to receive mitoxantrone (10 mg/m2 per day × 5) and etoposide (100 mg/m2 per day × 5) [ME], or cytarabine (200 mg/m2 per day × 7) and daunorubicin (45 mg/m2 per day × 3) [AD] as induction therapy. The randomization was stratified by age, onset of leukemia, and multidrug resistance phenotype. Over a 4-year period, 328 eligible patients from 66 institutions were enrolled. The complete remission rate was 34% (95% confidence interval [CI] 26%-41%) for patients in the ME and 43% (CI 35%-51%) for patients in the AD treatment arm (one-tailed P value .96). The rates of resistant disease were 43% (CI 35%-51%) and 34% (CI 27%-42%), respectively, for the 2 treatment arms (one-tailed P value .95). The estimated overall survival at 2 years was 11% (CI 6%-15%) and 19% (CI 12%-25%) for patients randomized to ME and to AD induction therapy, respectively (one-tailed P value .99). After accounting for the independent prognostic factors associated with survival (karyotype, performance status, age, white blood cell count), exploratory analysis suggested there was a worse survival for patients who received ME compared with AD induction therapy (2-tailed P value .0066). We conclude that the results of our study do not demonstrate any benefit to the use of ME induction chemotherapy instead of AD in older patients with AML. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. Greshock, J. Cheng, D. Rusnak, A. M. Martin, R. Wooster, T. Gilmer, K. Lee, B. L. Weber, and T. Zaks Genome-wide DNA copy number predictors of lapatinib sensitivity in tumor-derived cell lines Mol. Cancer Ther., April 1, 2008; 7(4): 935 - 943. [Abstract] [Full Text] [PDF] A. Pigneux, V. Perreau, E. Jourdan, N. Vey, N. Dastugue, F. Huguet, J.-J. Sotto, L. R. Salmi, N. Ifrah, and J. Reiffers Adding lomustine to idarubicin and cytarabine for induction chemotherapy in older patients with acute myeloid leukemia: the BGMT 95 trial results Haematologica, October 1, 2007; 92(10): 1327 - 1334. [Abstract] [Full Text] [PDF] E. 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