Optimal dose and schedule of consolidation in  AML: Is there a standard?

Publication date: September–December 2014 Source:Best Practice & Research Clinical Haematology, Volume 27, Issues 3–4 Author(s): Charles A. Schiffer Approximately 35%–40% of younger adults with acute myeloid leukemia (AML) can be cured using higher doses of cytosine arabinoside (ara-C) as post remission consolidation. Earlier studies focused on higher doses of 3 gms/m2, but since then numerous studies evaluating differences in dose, schedule, number of courses, and the addition of other agents, suggest that an intermediate-dose of ara-C may offer the greatest benefit to most patients with less toxicity than with higher dose regimens. In retrospect, this was predictable by the cellular pharmacology of ara-C. Perhaps most importantly, the overall outcome has not changed in the past 2-3 decades, indicating that the limits of available chemotherapy have been defined for AML. This review examines studies that have established the various dosing options and considers whether there is a true standard for post remission therapy for patients with AML.
Source: Best Practice and Research Clinical Haematology - Category: Hematology Source Type: research