Oral Idarubicin in the Treatment of AML

  • J.-L. Harousseau
Conference paper
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 39)


The current treatment of Acute Myeloid Leukemia (AML) is based on intensive chemotherapy at different steps (induction treatment, consolidation, treatment of relapse). Since these strategies induce prolonged and severe myelosuppression, all patients are nursed in specialized units and receive a number of intravenous supportive treatments (antibiotics, antifungal treatments, red blood cell and platelet transfusions, parenteral nutrition, etc.) which are administered through a central line. Therefore the place of oral chemotherapy appears very limited in the overall management of AML.

However, in some cases, giving an orally effective antileukemic drug partly on an outpatient basis could be an attractive alternative. These conditions include palliative therapy of relapsed or refractory AML, consolidation (or maintenance) therapy and induction therapy in poor-risk patients. Elderly patients represent the most important cohort in the latter category.


Acute Myeloid Leukemia Acute Myelogenous Leukemia Cytosine Arabinoside Oral Idarubicin Acute Nonlymphocytic Leukemia 
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  1. 1.
    Hamblin TJ (1995) Disappointments in treating acute leukemia in the elderly. N Engl J Med 332: 1712–1713PubMedCrossRefGoogle Scholar
  2. 2.
    Champlin RE, Gajewski JL, Golde DW (1989) Treatment of acute myelogenous leukemia in the elderly. Semin Oncol 16: 51–56PubMedGoogle Scholar
  3. 3.
    Liu Yin JA (1993) Acute myeloid leukaemia in the elderly: biology and treatment. Br J Haemato183: 1–6Google Scholar
  4. 4.
    Brincker H (1985) Estimates of overall treatment results in acute non-lymphocytic leukemia based on age-specific rates of incidence and of complete remission. Cancer Treat Rep 69: 511Google Scholar
  5. 5.
    Stone RM, Marye RI (1993) The approach to the elderly patient with acute myeloid leukemia. Hematol Oncol Clinics N America 7: 65–79Google Scholar
  6. 6.
    Row JM,Andersen J, Mazza JJ et al. (1993) A randomized placebo controlled phase III study of granulocyte-macrophage colony-stimulating factor in adult patients (55 to 70 years of age) with acute myelogenous leukemia. A study of the Eastern Cooperative Oncology Group. Blood 86: 457–462Google Scholar
  7. 7.
    Stone RM, Berg DT, George SL et al. (1995) Granulocyte-macrophage colony-stimulating factor after initial chemotheraphy for elderly patients with primary acute myelogenous leukemia. N Engl J Med 232: 1671–1677CrossRefGoogle Scholar
  8. 8.
    Dombret H, Chastang C, Fenaux Petal. (1995) A controlled study of recombinant human granulocyte colony-stimulating factor in elderly patient after treatment for acute myelogenous leukemia. N Engl J Med 232: 1678–1683CrossRefGoogle Scholar
  9. 9.
    Godwin JE, Kopecky KJ, Head DR et al. (1995) A double blind placebo controlled trial of G-CSF in elderly patients with previously untreated acute myeloid leukemia: a Southwest Oncology Group Study. Blood 86 (suppl 1): 434a (abstract)Google Scholar
  10. 10.
    Witz F, Harousseau JL, Sadoun A et al. (1995) GM-CSF during and after remission induction treatment for elderly patients with acute myeloid leukemia. Blood 86 (suppl 1): 512a (abstract)Google Scholar
  11. 11.
    Löwenberg B, Suciu S, Zittoun R et al. (1995) GM-CSF during as well as after induction chemotherapy in elderly patients with acute myeloid leukemia. Blood 86 (suppl 1): 433a (abstract)Google Scholar
  12. 12.
    Yates J, Glidewell O, Wiernik P et al. (1982) Cytosine-arabinoside with daunorubicin or adriamycin for therapy of acute myelocytic leukemia: a CALGB study. Blood 60: 454–462PubMedGoogle Scholar
  13. 13.
    Kahn SB, Begg CB, Mazza JJ et al. (1984) Full dose versus attenuated dose daunorubicin, cytosine arabinoside and 6-thioguanine in the treatment of acute non lymphocytic leukemia in the elderly. J Clin Oncol 42: 865–870Google Scholar
  14. 14.
    Cheson BD, Jaspere DM, Simon R et al. (1986) A critical appraisal of low-dose cytosine arabinoside in patients with acute non-lymphocytic leukemia and myelodysplastic syndromes. J Clin Oncol 4: 1857–1864PubMedGoogle Scholar
  15. 15.
    Powell BL, Capizzi RL, Muss HB et al. (1989) Low-dose ara-c therapy for acute myeloid leukemia in elderly patients. Leukemia 3: 23–28PubMedGoogle Scholar
  16. 16.
    Tilly H, Castaigne S, Bordessoule D et al. (1990) Low-dose cytarabine versus intensive chemotherapy in the treatment of acute non lymphocytic leukemia in the elderly. J Clin Oncol 8: 272–279PubMedGoogle Scholar
  17. 17.
    Berman E, Heller G, Santorsa J et al. (1991) Results of a randomized trial comparing idarubicin and cytosine arabinoside with daunorubicin and cytosine arabinoside in adult patients with newly diagnosed acute myelogenous leukemia. Blood 77: 1666–1674PubMedGoogle Scholar
  18. 18.
    Wiernik PH, Banks PL, Case DC et al. (1993) Cytarabine plus idarubicin or daunorubicin as induction and consolidation therapy for previously untreated adult patients with acute myeloid leukemia. Blood 79: 313–319Google Scholar
  19. 19.
    Vogler WR, Velez-Garcia E, Weiner RS et al. (1992) A phase III trial comparing idarubicin or daunorubicin in combination with cytarabine in acute myelogenous leukemia: a Southeastern Cancer Study Group. J Clin Oncol 10: 1184–1194Google Scholar
  20. 20.
    Gillies HC, Herriott D, Liang R et al. (1987) Pharmacokinetics of idarubicin following intravenous and oral administration in patients with advanced cancer. Brit J Clin Pharmaco 23: 303–310Google Scholar
  21. 21.
    Smith DB, Margison JM, Lucas SB et al. (1987) Clinical pharmacology of oral and intravenous 4-demethoxydaunorubicin. Cancer Chemother Pharmacol 19: 138–142PubMedCrossRefGoogle Scholar
  22. 22.
    Camaggi CM, Strocchi E, Carisi Petal. (1992) Idarubicin metabolism and pharmacokinetics after intravenous and oral administration in cancer patients: a crossover study. Cancer Chemother Pharmacol 30: 307–316PubMedCrossRefGoogle Scholar
  23. 23.
    Bezwoda WR, Dansey RD (1990) Idarubicin doxorubicin plus cytaraE;ine in induction therapy 1 leukemia: a randomized trial. Leukemia and Lymphoma 1: 221–225CrossRefGoogle Scholar
  24. 24.
    Lowenthal RM, Chesterman PN, Griffiths JD et al. (1987) idarubicin as single-agent treatment of acute nonlymphocytic leukemia in poor-risk patients. Cancer Treat Rep 71: 1279–1281PubMedGoogle Scholar
  25. 25.
    Keldsen N, Karle H, Hansen NE et al. (1990) Oral idarubicin in elderly patients with acute myeloid leukemia (letter). Eur J Haematol 45: 60PubMedCrossRefGoogle Scholar
  26. 26.
    Pagano L, Sica S, Marra R (1991) Oral idarubicin plus cytosine arabinoside in the treatment of acute non lymphoblastic leukemia in elderly patients. Haematologica 76: 517–518PubMedGoogle Scholar
  27. 27.
    Harousseau JL, Rigal-Huguet F, Hurteloup P et al. (1989) Treatment of acute myeloid leukemia in elderly patients with oral idarubicin as a single agent. Eur J Haematol 42: 182–185PubMedCrossRefGoogle Scholar
  28. 28.
    Harousseau JL, Huguet F, Reiffers J et al. (1991) Oral idarubicin and low dose cytarabine as the initial treatment of acute myeloid leukemia in elderly patients. Leuk Lymphom 15: 145–149CrossRefGoogle Scholar
  29. 29.
    Ruutu T, Almquist A, Hallman H et al. (1994) Oral induction and consolidation of acute myeloid leukemia with etoposide, 6-thioguenine, and idarubicin (ETI) in elderly patients: a randomized comparison with 5-day TAD. Leukemia 8: 11–15PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • J.-L. Harousseau
    • 1
  1. 1.Service d’Hématologie CliniqueCHU de NantesNantes CedexFrance

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