Summary of included trials
. | Treatment protocol . | . | . | . | . | . | . | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 8525a . | 8923b . | 9022c . | 9222d . | 9420e . | 9621f . | 9720g . | ||||||
Years of patient accrual | 10/85-10/90 | 2/90-11/93 | 10/90-3/92 | 7/92-12/95 | 1/95-7/97 | 2/97-3/00 | 1/98-3/99 | ||||||
Trial phase | 3 | 3 | 2 | 3 | 1 | 1/2 | 3 | ||||||
Patientsh | |||||||||||||
Total | 1036 | 360 | 213 | 407 | 103 | 340 | 111 | ||||||
White, no. (%) | 920 (89) | 334 (93) | 192 (90) | 354 (87) | 94 (91) | 301 (89) | 105 (95) | ||||||
African American, no. (%) | 116 (11) | 26 (7) | 21 (10) | 53 (13) | 9 (9) | 39 (11) | 6 (5) | ||||||
Cytogenetics available, no. (%) | 563 (54) | 210 (58) | 124 (58) | 269 (66) | 62 (60) | 270 (79) | 82 (74) | ||||||
Induction 1l | Yes | Yesi | Yes | Yes | Yesj | Yesj | Yesj | ||||||
Etoposide used in inductions 1 (and 2, if needed) | No | No | No | No | Yes: 60 or 100 mg/m2/d × 3 days | Yes: 60-150 mg/m2/d × 3 days | Yes: 60 or 100 mg/m2/d × 3 days | ||||||
Induction 2, if needed | Yes | Yes | Yes | Yes | Yesk | Yesk | Yesk | ||||||
Intensification or consolidation therapy randomized, by arm | Yes, arms A, B, C | Yes, arms A, B | No | Yes, arms A, B | No | Yes, risk-adapted, arms A, B | No | ||||||
Intensification or consolidation therapy 1, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: M + IDAC | HDAC | A: HDAC; B: HDAC | 5 + 2 + 2 | A:HDAC; B: HDAC + E | 5 + 2 + 2 | ||||||
Intensification or consolidation therapy 2, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: M + IDAC | E + C | A: HDAC; B: E + C | - | A: HDAC; B: SCT | - | ||||||
Intensification or consolidation therapy 3, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: None | M + D | A: HDAC; B: M + D | - | A: HDAC; B: None | - | ||||||
Intensification or consolidation therapy 4, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: None | - | - | - | - | - | ||||||
Maintenance therapy | Yes | No | No | No | Yes | Yes | Yes |
. | Treatment protocol . | . | . | . | . | . | . | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
. | 8525a . | 8923b . | 9022c . | 9222d . | 9420e . | 9621f . | 9720g . | ||||||
Years of patient accrual | 10/85-10/90 | 2/90-11/93 | 10/90-3/92 | 7/92-12/95 | 1/95-7/97 | 2/97-3/00 | 1/98-3/99 | ||||||
Trial phase | 3 | 3 | 2 | 3 | 1 | 1/2 | 3 | ||||||
Patientsh | |||||||||||||
Total | 1036 | 360 | 213 | 407 | 103 | 340 | 111 | ||||||
White, no. (%) | 920 (89) | 334 (93) | 192 (90) | 354 (87) | 94 (91) | 301 (89) | 105 (95) | ||||||
African American, no. (%) | 116 (11) | 26 (7) | 21 (10) | 53 (13) | 9 (9) | 39 (11) | 6 (5) | ||||||
Cytogenetics available, no. (%) | 563 (54) | 210 (58) | 124 (58) | 269 (66) | 62 (60) | 270 (79) | 82 (74) | ||||||
Induction 1l | Yes | Yesi | Yes | Yes | Yesj | Yesj | Yesj | ||||||
Etoposide used in inductions 1 (and 2, if needed) | No | No | No | No | Yes: 60 or 100 mg/m2/d × 3 days | Yes: 60-150 mg/m2/d × 3 days | Yes: 60 or 100 mg/m2/d × 3 days | ||||||
Induction 2, if needed | Yes | Yes | Yes | Yes | Yesk | Yesk | Yesk | ||||||
Intensification or consolidation therapy randomized, by arm | Yes, arms A, B, C | Yes, arms A, B | No | Yes, arms A, B | No | Yes, risk-adapted, arms A, B | No | ||||||
Intensification or consolidation therapy 1, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: M + IDAC | HDAC | A: HDAC; B: HDAC | 5 + 2 + 2 | A:HDAC; B: HDAC + E | 5 + 2 + 2 | ||||||
Intensification or consolidation therapy 2, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: M + IDAC | E + C | A: HDAC; B: E + C | - | A: HDAC; B: SCT | - | ||||||
Intensification or consolidation therapy 3, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: None | M + D | A: HDAC; B: M + D | - | A: HDAC; B: None | - | ||||||
Intensification or consolidation therapy 4, by arm | A: SDAC; B: IDAC; C: HDAC | A: SDAC; B: None | - | - | - | - | - | ||||||
Maintenance therapy | Yes | No | No | No | Yes | Yes | Yes |
SDAC indicates 100 mg/m2 cytarabine by ci every day × 5 days; IDAC, 400 mg/m2 cytarabine by ci every day × 5 days; HDAC, 3 g/m2 cytarabine by intravenous bolus (ivb) over 3 hours every 12 hours on days 1, 3 and 5; HDAC + E, 2 mg/m2 cytarabine by ivb over 2 hours every 12 hours on days 1-4 and 40 mg/kg etoposide by ci every day for 4 days; M + IDAC, 5 mg/m2 mitoxantrone every 12 hours and 500 mg/m2 cytarabine every 12 hours for 6 doses each; E + C, 1800 mg/m2 etoposide by ci day 1 plus 50 mg/kg cyclophosphamide ivb on days 2 and 3; M + D, 12 mg/m2 mitoxantrone ivb plus 24 mg/m2 diaziquone by ci days 1, 2, and 3 plus 5 μg/kg filgrastim subcutaneously days 4 through 28; 5 + 2 + 2, 100 mg/m2 cytarabine by continuous infusion every day × 5 days plus 2 days of daunorubicin and etoposide at doses equivalent to those received in induction 1, ± PSC 833. Maintenance therapy for study 8525 consisted of 45 mg/m2 daunorubicin ivb on day 1 plus 100 mg/m2 cytarabine subcutaneously every 12 hours on days 1 through 5 repeated monthly × 4; for studies 9420, 9621, and 9720, maintenance therapy consisted of interleukin-2 as specified by Farag et al30 and Baer et al.31 ivp indicates intravenous push; SCT, stem cell transplantation; and -, not applicable.
Mayer et al.24
Stone et al.25,36
Moore et al.26
Moore et al.27
Lee et al.28
Kolitz et al.29
Baer et al.31
Patient population data are as follows: total, N = 2570; white, n = 2300 (89.5% of total); African American, n = 270 (10.5% of total); and cytogenetics available, n = 1580 (61% of total)
50% of enrolled patients received granulocyte-macrophage colony-stimulating factor (GM-CSF) during induction
Patients in 9420 received daunorubicin at doses ranging from 30 to 60 mg/m2/d × 3 days and also received the multidrug resistance modulator PSC 833 at a loading dose of 1.5 mg/kg and a continuous infusion of 10 mg/kg/d for 3 days; patients in 9621 received daunorubicin at doses ranging from 40 to 90 mg/m2/d × 3 days depending on their randomization to PSC 833 at a loading dose of 2.8 mg/kg and a continuous infusion of 10 mg/kg/d for 3 days; patients in 9720 received daunorubicin at doses of 40 or 60 mg/m2/d × 3 days depending on their randomization to PSC 833 at a loading dose of 2.8 mg/kg and a continuous infusion of 10 mg/kg/d for 3 days
Doses were equivalent to those received in induction 1. Patients receiving PSC 833 for induction 1 received it for induction 2 over 2 days
Induction 1 consisted of daunorubicin 45 mg/m2 ivp × 3 days and cytarabine 100 or 200 mg/m2 by continuous infusion (ci) × 7 days. Induction 2, which was administered if needed, consisted of daunorubicin 45 mg/m2 ivp × 2 days and cytarabine 100 or 200 mg/m2 by ci × 5 days