Acute myeloid leukemia (AML) is a clinically and biologically heterogeneous disease
characterized by the clonal expansion of undifferentiated myeloid precursors. Although
induction chemotherapy with cytarabine and daunorubicin/Idarubicin, typically called "7+3",
has not changed for several decades, the best dosage of anthracycline is still unknown.
Several prospective trials have demonstrated that intense dosage of anthracycline improved
complete remission (CR) and overall survival (OS). Idarubicin 12mg/m2 (IA12) has been shown
to be equal to dose intense daunorubicin (90 mg/m2 ) for achieving CR. Dose-intense
daunorubicin 90 mg/m2 (DA90) has been shown to improve CR compared to standard dose
daunorubucin 45mg/m2 in newly diagnosed AML patients. In our previous study, CR rate of
induction with daunorubicin 60 mg/m2/d (3 days) and cytarabine 200 mg/m2/d days 1-7 was about
67%. Benefit of intensification seems limited to the patients without adverse cytogenetics.
Wheher ultra high dose idarubicin 14mg/m2 (IA14) could further improve CR rate, give patients
with adverse cytogenetics a chance to do allo-stem cell transplantation? This phase 2,
prospective, single-center study is designed to evaluate the efficacy and safety of induction
with idarubicin 14mg/m2/d (3 days) and cytarabine 200 mg/m2/d days 1-7 in young newly
diagnosed AML patients.