Randomized Comparison of DAT Versus ADE as Induction Chemotherapy in Children and Younger Adults With Acute Myeloid Leukemia. Results

The relative efficacy and toxicity of the chemotherapeutic dation chemotherapy with ADE (9%) than with DAT (6%) (P ! .06). Patients receiving DAT took slightly but significantly agents thioguanine (6TG) and etoposide (VP16) were assessed by a randomized comparison of the DAT (daunorulonger to recover from neutropenia and thrombocytopenia but the median number of days in hospital were similar in bicin, cytarabine, thioguanine) versus ADE (daunorubicin, cytarabine, etoposide) regimens in the Medical Research each group. ADE patients experienced slightly more severe nonhematologic toxicity. There was also no significant difCouncil’s 10th acute myeloid leukaemia trial (MRC AML 10), which was open to patient entry from May 1988 to April ference between the groups in the longer-term measures of efficacy: disease-free survival at 6 years from CR was 42% 1995. In this, the largest reported trial of AML therapy to date, 1,857 eligible patients, mostly less than 56 years old, (Ô4) for DAT and 43% (Ô4) for ADE (P ! .8); relapse rate at 6 years was 50% (Ô4) for DAT and 49% (Ô5) for ADE (P ! were randomized: 929 (including 143 children under 15 years old) were allocated to DAT and 928 (143 children) to ADE. .6); survival at 6 years was 40% (Ô4) for both DAT and ADE (P ! .9). Subgroup analysis failed to show any benefit for The two groups were well matched for presentation features. The complete remission (CR) rate was 81% with DAT etoposide in patients with monocytic or myelomonocytic disease, or in any other diagnostic subgroup. In conclusion, and 83% with ADE (P ! .3). The percentages of remitters achieving remission after 1, 2, or more than 2 courses were DAT and ADE both achieve high remission rates and good long-term survival, and are equally effective chemotherapy 70%, 22%, and 8% for DAT and 74%, 21%, and 5% for ADE. The percentages failing to achieve a CR due to resistant regimens for the treatment of AML patients aged up to 55 years. disease were 11% with DAT versus 9% with ADE (P ! .07). There was a slightly higher death rate in CR during consoliq 1997 by The American Society of Hematology.