Timed sequential therapy for acute myelogenous leukemia: Results of a retrospective study of 301 patients and review of the literature

摘要: Timed sequential therapy (TST) aims to improve outcomes in acute myelogenous leukemia (AML) by harnessing drug-induced cell cycle kinetics of AML, where a second drug is timed coincide with peak proliferation induced the first drugs. We analyzed 301 newly diagnosed AML patients treated from 2004-2013 cytarabine, anthracycline, and etoposide TST induction. Median age was 52 (range 20-74) complete remission rate 68%. With median follow-up 5.8 years, 5-year DFS overall survival (OS) were 37% (95% CI 31-45%) 32% 27-38%), respectively. In multivariate analysis, older age, unfavorable cytogenetics, WBC≥50×109/L resulted worse OS. Among not undergoing blood marrow transplant, propensity score which reduces imbalance baseline characteristics, showed consolidation compared 1 or more cycles high-dose cytarabine trended toward lower post-remission hazard ratio (HR) 1.9 0.9-4.0), 1.6 0.7-3.6), Our results demonstrate efficacy feasibility induction for comparable that seen clinical trials other therapies 7+3.