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High-dose homoharringtonine versus standard-dose daunorubicin is effective and safe as induction and post-induction chemotherapy for elderly patients with acute myeloid leukemia: a multicenter experience from China

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Abstract

The purpose of the study was to compare the antitumor efficacy and safety profile of high-dose homoharringtonine as induction and post-induction therapy compared to either standard-dose homoharringtonine or daunorubicin in elderly patients with newly diagnosed acute myeloid leukemia. A total of 254 patients, age range 60–77 years received induction and post-induction therapy containing daunorubicin, standard-dose homoharringtonine, or high-dose homoharringtonine. After one course of induction therapy, the overall complete remission rate was similar between treatment arms (58.7%, P = .92). Among 161 patients with acute myeloid leukemia (non-M5 subtype), estimated median overall survival was 39, 29, and 37 months, respectively, in the daunorubicin, standard-dose homoharringtonine, and high-dose homoharringtonine treatment groups (P = .53). In the 93 patients with acute myeloid leukemia-M5 subtype, there was a significant difference in estimated median overall survival: 24, 24, and 52 months, respectively, in the daunorubicin, standard-dose homoharringtonine, and high-dose homoharringtonine treatment groups (P = .003). There was no significant difference in drug-related adverse events between treatment arms. High-dose homoharringtonine does not clearly increase the complete remission rate of elderly patients with acute myeloid leukemia. However, in the subset of elderly patients with acute monocytic leukemia, high-dose homoharringtonine as a first-line regimen prolonged overall survival with minimal toxicity.

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Acknowledgments

We would like to thank all the patients and the clinicians from the participating sites. This work was supported by grants from the Key Programs of Science and Technology of Guangzhou City (2006Z3-E0401).

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Authors and Affiliations

  1. Department of Hematology Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, 510515, Guangzhou, People’s Republic of China

    Bin-Tao Huang & Xiao-Li Liu

  2. Department of Critical Care Medicine, The Affiliated Hospital of Guangdong Medical College, 524001, Zhanjiang, People’s Republic of China

    Qing-Chun Zeng

  3. Department of Surgery, School of Medicine, University of Colorado Denver, Aurora, CO, 80045, USA

    Jessica Yu

  4. Department of Hematology Medicine, The Affiliated Hospital of Inner Mongolia Medical College, Hohhot, 010059, People’s Republic of China

    Zhen Xiao

  5. Department of Hematology Medicine, The People’s Hospital of Guizhou Province, 550004, Guiyang, People’s Republic of China

    Hong-Qian Zhu

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  1. Bin-Tao Huang
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  2. Qing-Chun Zeng
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  3. Jessica Yu
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  4. Xiao-Li Liu
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Correspondence to Xiao-Li Liu.

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Bin-Tao Huang and Qing-Chun Zeng equally contributed to this work.

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Huang, BT., Zeng, QC., Yu, J. et al. High-dose homoharringtonine versus standard-dose daunorubicin is effective and safe as induction and post-induction chemotherapy for elderly patients with acute myeloid leukemia: a multicenter experience from China. Med Oncol 29, 251–259 (2012). https://doi.org/10.1007/s12032-011-9820-4

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  • DOI: https://doi.org/10.1007/s12032-011-9820-4

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