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Blood, 15 June 2007, Vol. 109, No. 12, pp. 5129-5135. Prepublished online as a Blood First Edition Paper on March 6, 2007; DOI 10.1182/blood-2007-02-069666. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2007-02-069666v1 109/12/5129    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 Gardin, C. Articles by Dombret, H. Search for Related Content PubMed PubMed Citation Articles by Gardin, C. Articles by Dombret, H. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted February 1, 2007 Accepted March 5, 2007 Post-remission treatment of elderly patients with acute myeloid leukemia in first complete remission after intensive induction chemotherapy - results of the multicenter randomized Acute Leukemia French Association (ALFA) 9803 trial Claude Gardin, Pascal Turlure, Thierry Fagot, Xavier Thomas, Christine Terre, Nathalie Contentin, Emmanuel Raffoux, Stephane de Botton, Cecile Pautas, Oumedaly Reman, Jean-Henri Bourhis, Pierre Fenaux, Sylvie Castaigne, Mauricette Michallet, Claude Preudhomme, Thierry de Revel, Dominique Bordessoule, and Herve Dombret* Department of Hematology, Hopital Avicenne, Bobigny, France Department of Hematology, Centre Hospitalier Universitaire, Limoges, France Department of Hematology, Hopital Percy, Clamart, France Department of Hematology, Centre Hospitalier Universitaire, Lyon, France Department of Hematology, Hopital Mignot, Versailles, France Department of Hematology, Centre Leon Becquerel, Rouen, France Department of Hematology, Hopital Saint-Louis, Paris, France Department of Hematology, Centre Hospitalier Universitaire, Lille, France Department of Hematology, Hopital Henri Mondor, Creteil, France Department of Hematology, Centre Hospitalier Universitaire, Caen, France Department of Hematology, Institut Gustave Roussy, Villejuif, France * Corresponding author; email: herve.dombret{at}sls.aphp.fr. In elderly patients with acute myeloid leukemia (AML) treated intensively, no best post-remission strategy has emerged yet. This clinical trial enrolled 416 AML patients aged 65 years or more considered as eligible for standard intensive chemotherapy, with a first randomization comparing idarubicin to daunorubicin as anthracycline for all treatment sequences. After induction, an ambulatory post-remission strategy based on 6 consolidation cycles administered monthly in out-patients was randomly compared to an intensive strategy with 1 single intensive consolidation course similar to induction. Complete remission (CR) rate was 57% with 10% induction deaths and estimated overall survival was 27% at 2 years and 12% at 4 years, without notable differences between both anthracycline arms. Among the 236 patients who reached CR, 164 (69%) were randomized for the post-remission comparison. In these patients, the multivariate odds ratio in favor of the ambulatory arm was 1.51 for disease-free survival (P=0.05) and 1.59 for overall survival from CR (P=0.04). Despite repeated courses of chemotherapy associated with a longer time under treatment, the ambulatory arm was associated with significantly shorter re-hospitalization duration and lower red blood cell unit and platelet transfusion requirement than observed in the intensive arm. In conclusion, more prolonged ambulatory treatment should be preferred to intensive chemotherapy as post-remission therapy in elderly patients with AML reaching CR after standard intensive remission induction. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. Yanada, G. Garcia-Manero, G. Borthakur, F. Ravandi, H. Kantarjian, and E. Estey Relapse and death during first remission in acute myeloid leukemia Haematologica, April 1, 2008; 93(4): 633 - 634. [Full Text] [PDF] F. R. Appelbaum Indications for Hematopoietic Cell Transplantation for the Treatment of Adult Acute Leukemia ASCO Educational Book, January 1, 2008; 2008(1): 325 - 329. [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] AML Therapy in Elders Journal Watch Oncology and Hematology, July 16, 2007; 2007(716): 6 - 6. [Full Text]

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