Anthracycline versus Non-Anthracycline Induction Regimens in Patients with De Novo Acute Myeloid Leukemia

Background & Objectives: Acute myeloid leukemia (AML) is the most prevalent form of acute leukemias in adults; unfortunately it carries very poor prognosis. Over the past decade marvelous advances were achieved in understanding pathophysiology of AML and this was reflected in management of AML patients. Nevertheless the standard anthracycline based induction regimens remained the cornerstone for treatment of AML; however their effectiveness is limited by their well known cardiotoxicity. To our knowledge this is the first study that investigated anthracycline versus non-anthracycline induction regimens in patients with AML. Methods: 90AML patients were enrolled in the study; they were retrospectively recruited from AML patients who were admitted at South Egypt Cancer Institute (SECI) from 2000-2010. Demographic, clinical, hematologic and data concerning treatment and therapeutic response were collected from hospital records of patients. Results: Analysis of the collected data showed lower median age of the study participants compared to other studies, FAB M2, M3, M4, followed by M1 were the commonest FAB subtypes among the study patients. Survival analysis showed longer overall survival (OS) and progression free survival (PFS) in those treated with anthracycline induction regimens compared with the non-anthracycline treated group. Also, higher incidence of relapse was observed in the non-anthracycline group. Conclusion: Anthracycline based induction regimens are still more effective than non-anthracycline regimens for treatment of AML, however the search for safer drugs than anthracyclines is still mandatory.