Treatment approaches on “standard arm” of recent phase 3 US AML protocols
| Component . | AAML0531 (COG)42 . | E1900 (ECOG)59 . |
|---|---|---|
| Induction | Induction I: IT cytarabine Cytarabine 100 mg/m2 D1-10 Daunorubicin 50 mg/m2 D1,3,5 Etoposide 100 mg/m2 D1-5 Induction II (timed): IT cytarabine Cytarabine 100 mg/m2 D1-8 Daunorubicin 50 mg/m2 D1,3,5 Etoposide 100 mg/m2 D1-5 | Induction: Cytarabine 100 mg/m2 D1-7 Daunorubicin 45 mg/m2 D1-3 |
| Consolidation | Intensification I: IT cytarabine Cytarabine 1 g/m2 Q 12 h D1-5 Etoposide 150 mg/m2 D1-5 Intensification II: IT cytarabine Cytarabine 1 g/m2 Q 12 h D1-4 Mitoxantrone 12 mg/m2 D3-6 Intensification III: Cytarabine 3 g/m2 Q 12 h D1,2,8,9 L-asparaginase 6000 IU/m2 D2,9 | Cycle I: Cytarabine 3 g/m2 Q 12 h D1,3,5 Cycle II: Cytarabine 3 g/m2 Q 12 h D1,3,5 Autologous stem cell transplantation |
| Allogeneic transplant | High- or intermediate-risk (cytogenetics other than inv16 or 8;21, or FLT3 ITD-AR > 0.4, or > 15% marrow blasts after induction I) and HLA-matched sibling available; alternative donors permitted for high-risk patients | High- or intermediate-risk (unfavorable or intermediate cytogenetics, WBCs at diagnosis > 100 000) and HLA-matched sibling available |
| Component . | AAML0531 (COG)42 . | E1900 (ECOG)59 . |
|---|---|---|
| Induction | Induction I: IT cytarabine Cytarabine 100 mg/m2 D1-10 Daunorubicin 50 mg/m2 D1,3,5 Etoposide 100 mg/m2 D1-5 Induction II (timed): IT cytarabine Cytarabine 100 mg/m2 D1-8 Daunorubicin 50 mg/m2 D1,3,5 Etoposide 100 mg/m2 D1-5 | Induction: Cytarabine 100 mg/m2 D1-7 Daunorubicin 45 mg/m2 D1-3 |
| Consolidation | Intensification I: IT cytarabine Cytarabine 1 g/m2 Q 12 h D1-5 Etoposide 150 mg/m2 D1-5 Intensification II: IT cytarabine Cytarabine 1 g/m2 Q 12 h D1-4 Mitoxantrone 12 mg/m2 D3-6 Intensification III: Cytarabine 3 g/m2 Q 12 h D1,2,8,9 L-asparaginase 6000 IU/m2 D2,9 | Cycle I: Cytarabine 3 g/m2 Q 12 h D1,3,5 Cycle II: Cytarabine 3 g/m2 Q 12 h D1,3,5 Autologous stem cell transplantation |
| Allogeneic transplant | High- or intermediate-risk (cytogenetics other than inv16 or 8;21, or FLT3 ITD-AR > 0.4, or > 15% marrow blasts after induction I) and HLA-matched sibling available; alternative donors permitted for high-risk patients | High- or intermediate-risk (unfavorable or intermediate cytogenetics, WBCs at diagnosis > 100 000) and HLA-matched sibling available |
COG indicates Children's Oncology Group; ECOG, Eastern Cooperative Oncology Group; IT, intrathecal; D, day; Q, every; and WBCs, white blood cells.