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Prepublished online as a Blood First Edition Paper on September 25, 2003; DOI 10.1182/blood-2003-05-1686. This Article Full Text (PDF) All Versions of this Article: 2003-05-1686v1 103/2/479    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 Rowe, J. M Articles by Wiernik, P. H Search for Related Content PubMed PubMed Citation Articles by Rowe, J. M Articles by Wiernik, P. H Social Bookmarking                   What's this? Submitted May 29, 2003 Accepted September 16, 2003 A phase III study of three induction regimens and of priming with GM-CSF in older adults with acute myeloid leukemia: a trial by the Eastern Cooperative Oncology Group Jacob M Rowe*, Donna Neuberg, William Friedenberg, John M Bennett, Elisabeth Paietta, Adel Z Makary, Jane L Liesveld, Camille N Abboud, Gordon Dewald, F Ann Hayes, Martin S Tallman, and Peter H Wiernik Departments of Hematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel Division of Biostatistics, Dana Farber Cancer Institute, Boston, MA, USA Department of Oncology, Guthrie Medical Center, Sayre, PA, USA Medical Oncology Unit, Univeristy of Rochester Cancer Center, Rochester, NY, USA Immunology Lab, Our Lady of Mercy Cancer Center, New York, NY, USA Hematology/Oncology, Geisinger Medical Center, Danville, PA, USA Departments of Lab Medicine & Pathology, Mayo Clinic, Rochester, MN, USA Immunex Corp., Seattle, WA, USA Department of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA * Corresponding author; email: rowe{at}jimmy.harvard.edu. The optimal induction for older adults with acute myeloid leukemia (AML) is unknown. Several anthracyclines have been proposed, but the data remain equivocal. Additionally, few prospective trials of priming with hematopoietic growth factors to cycle leukemia cells prior to induction chemotherapy have been conducted. Three hundred and sixty-two older adults with previously untreated AML were randomized to either daunorubicin, idarubicin or mitoxantrone with a standard dose of cytarabine as induction therapy. Two hundred and forty-five patients were also randomized to receive granulocyte-macrophage colony-stimulating factor or placebo beginning two days prior to induction chemotherapy and continuing until marrow aplasia. No difference was observed in the disease-free, overall survival or toxicity among patients receiving any of the three induction regimens or among those receiving growth factor or placebo for priming. However, the complete remission rate for the first 113 analyzable patients, who did not participate in the priming study and started induction therapy 3 to 5 days earlier than those who did, was significantly higher (50% versus 38%; p= 0.03). None of the anthracyclines is associated with improved outcome in older adults. Priming with hematopoietic growth factor did not improve response when compared with placebo. Furthermore, delaying induction therapy in older adults may lead to a lower complete remission rate. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: F. Mandelli, M. Vignetti, S. Suciu, R. Stasi, M.-C. Petti, G. Meloni, P. Muus, F. Marmont, J.-P. Marie, B. Labar, et al. Daunorubicin Versus Mitoxantrone Versus Idarubicin As Induction and Consolidation Chemotherapy for Adults With Acute Myeloid Leukemia: The EORTC and GIMEMA Groups Study AML-10 J. Clin. 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