Is the current consolidation regimen for AML evidence-based?

Abstract

Current standard of care for consolidation therapy for AML varies based on age and induction regimen, among other factors. Many trials have sought to determine the optimal dose, number of cycles, and schedule for consolidation with cytarabine. For AML patients under age 60, mid-dose cytarabine is as effective as high-dose cytarabine, results after 3 or 4 cycles of cytarabine in consolidation are comparable but are both superior to only one cycle, and giving cytarabine every 12 h on days 1, 2, and 3 appears to have the same benefit but less toxicity than cytarabine given on days 1, 3, and 5. For those over age 60, the best dose of cytarabine is unknown, but post-remission therapy appears to improve survival for some patients who achieve remission after standard induction, depending on induction regimen used and MRD status at time of remission.

Keywords: 7+3; AML; Acute myeloid leukemia; Cytarabine.