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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 (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 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 Social Bookmarking                   What's this? Submitted December 31, 2001 Accepted May 29, 2002 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 Katmai Oncology Group, Anchorage, AK, USA Southwest Oncology Statistical Group, Seattle, WA, USA University of New Mexico, Albuquerque, NM, USA Vanderbilt University Medical Center, Nashville, TN, USA City of Hope National Medical Center, Duarte, CA, USA Puget Sound Oncology Consortium, Seattle, WA, USA Ohio State University Health Center, Columbus, OH, USA Witchita Community Clinical Onccology Program, Witchita, KS, USA * Corresponding author; email: jeanderson{at}ak.net. Complete remission and long-term survival rates are low for older adults treated for acute myeloid leukemia (AML). Because of favorable phase II data using mitoxantrone and etoposide, we conducted a phase III study (SWOG-9333) in which patients over 55 years of age with previously untreated AML were randomized to receive mitoxantrone (10 mg/m2/day x 5) and etoposide (100 mg/m2/day x 5) [ME] or cytarabine (200 mg/m2/day x 7) and daunorubicin (45 mg/m2/day x 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 0.96). 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 0.95). 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 0.99). 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 to AD induction therapy (two-tailed p-value 0.0066). 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. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. D. Schimmer, E. H. Estey, G. Borthakur, B. Z. Carter, G. J. Schiller, M. S. Tallman, J. K. Altman, J. E. Karp, J. Kassis, D. W. Hedley, et al. 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