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Blood, 23 April 2009, Vol. 113, No. 17, pp. 3903-3910. Prepublished online as a Blood First Edition Paper on January 8, 2009; DOI 10.1182/blood-2008-07-162842. This Article Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2008-07-162842v1 113/17/3903    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Braess, J. Articles by Hiddemann, W. Search for Related Content PubMed PubMed Citation Articles by Braess, J. Articles by Hiddemann, W. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 8, 2008 Accepted December 12, 2008 Dose-dense induction with sequential-high-dose cytarabine and mitoxantone (S-HAM) and pegfilgrastim results in a high efficacy and a short duration of critical neutropenia in de-novo acute myeloid leukemia - a pilot study of the AML-CG Jan Braess*, Karsten Spiekermann, Peter Staib, Andreas Gruneisen, Bernhard Wormann, Wolf-Dieter Ludwig, Hubert Serve, Albrecht Reichle, Rudolf Peceny, Daniel Oruzio, Christoph Schmid, Xaver Schiel, Marcus Hentrich, Christina Sauerland, Michael Unterhalt, Michael Fiegl, Wolfgang Kern, Christian Buske, Stefan Bohlander, Achim Heinecke, Herrad Baurmann, Dietrich W. Beelen, Wolfgang E. Berdel, Thomas Buchner, and Wolfgang Hiddemann Klinikum Grosshadern der LMU Munchen, Munich, Germany Universitatsklinikum Koln, Cologne, Germany Vivantes Klinikum, Berlin-Neukolln, Germany Stadtisches Klinikum Braunschweig, Braunschweig, Germany Robert-Rossle-Klinik, Campus Berlin-Buch, Berlin, Germany Klinikum der J.W. Goethe-Universitat, Frankfurt, Germany Klinikum der Universitat Regensburg, Regensburg, Germany Klinikum Osnabruck, Osnabruck, Germany Zentralklinikum Augsburg, Augsburg, Germany Stadtisches Klinikum Munchen, Klinikum Harlaching, Munich, Germany Institut fur Medizinische Informatik und Biomathematik, Universitat Munster, Munster, Germany MLL Munchner Leukamielabor, Munich, Germany Deutsche Klinik fur Diagnostik, Wiesbaden, Germany Universitatsklinikum Essen, Essen, Germany Universitatsklinikum Munster, Munster, Germany * Corresponding author; email: jan.braess{at}med.uni-muenchen.de. Dose density during early induction has been demonstrated to be one of the prime determinants for treatment efficacy in acute myeloid leukemia (AML). The German AML-Cooperative Group has therefore piloted a dose dense induction regimen S-HAM (sequential high-dose AraC and Mitoxantrone followed by pegfilgrastim) in which two induction cycles are applied over 11 - 12 days instead of 25 - 29 days as used in conventional double induction thereby increasing dose density two-fold. Of 172 de-novo AML patients (excluding acute promyelocytic leukemia) 61% reached a complete remission, 22% a complete remission with incomplete peripheral recovery, 7% had persistent leukemia, 10% succumbed to early death - resulting in an overall response rate of 83%. Kaplan Meier estimated survival at 2 years was 75% for the whole group [patients with unfavourable karyotypes 38%; patients with favourable karyotypes 69%; patients with intermediate karyotypes 75%] after S-HAM treatment. Importantly the compression of the two induction cycles into the first 11 - 12 days of treatment was beneficial for normal hematopoesis as demonstrated by a significantly shortened duration of critical neutropenia of 31 days as compared to 46 days after conventionally timed double induction. The clinical study is an official study of the "Kompetenznetz Akute und Chronische Leukamien" and is registered in the European Leukemia Trial Registry with the registration number LN_AMLINT_2004_230. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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