Beyond A CR - Postinduction Options
With A Compendium Of Articles On Critical Choices In Aml Today

Achieving A CR

SIGNIFICANTLY LESS RESISTANT DISEASE OCCURS WITH IDAMYCIN IN THE REGIMEN

• Less resistant disease due to persistent blasts means greater responses
• Greater responses lead to more postinduction options for patients

SIGNIFICANTLY FEWER PATIENTS HAVE HAD PERSISTENT BLASTS* ON THE IDAMYCIN ARM IN EACH STUDY

Abbreviations: IDA, idarubicin; DNR, daunorubicin *Of evaluable or assessable patients

SIGNIFICANTLY HIGHER CR RATES OCCUR WITH IDAMYCIN IN THE REGIMEN**

• Consistently more CRs achieved after the first course of therapy
• More durable therapy with consistently longer CRs Greater responses, more opportunity for postinduction options

**In two of three US studies.

CR RATES CONSISTENTLY HIGHER ON THE IDAMYCIN ARM IN EACH STUDY

	CRs after one course	CRs after two courses
Berman1			P=.005
Wiernick2			P=.08
Vogler3			P=.03
Abbreviations: IDA, idarubicin; DNR, daunorubicin

ACHIEVING A CR WITH MINIMAL RESISTANT DISEASE —
ESSENTIAL FOR POSTINDUCTION OPTIONS

Allogeneic Transplantation

• Most common reasons that patients aged <= 40 years with an HLA match did NOT undergo BMT were primary refractory disease and short complete remission (< 3 mo).^[4]

Autologous Transplantation

• Purging autologous bone marrow using monoclonal antibodies and cytotoxic agents can help achieve long-term DFS in many AML patients.^[5]

Immunotherapy

• "IL-2 appears to represent a therapeutic option for AML patients with limited/minimal residual disease."^[6]

ACHIEVING A CR AND BEYOND — IN AML

Significantly fewer patients with resistant disease

Significantly higher complete remission rates*

Significantly longer survival*

Superior therapeutic profile during induction*

And options for postinduction therapy

*In two of three US studies

TIME IS OF THE ESSENCE

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References:

1. Berman E, Heller G, Santorsa J, et al. 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. 1991;77:1666-1674.
2. Wiernik PH, Banks PLC, Case DC Jr, et al. Cytarabine plus idarubicin or daunorubicin as induction and consolidation therapy for previously untreated adult patients with acute myeloid leukemia. Blood. 1992;79:313-319.
3. Vogler WR, Velez-Garcia E, Weiner RS, et al. A phase III trial comparing idarubicin and daunorubicin in combination with cytarabine in acute myelogenous leukemia: a Southeastern Cancer Study Group study. J Clin Oncol. 1992;10:1103-1111.
4. Berman E, Little C, Gee T, et al. Reasons that patients with acute myelogenous leukemia do not undergo allogeneic bone marrow transplantation. N Engl J Med. 1992;326:156-160.
5. Selvaggi KJ, Wilson JW, Mills LE, et al. Improved outcome for high-risk acute myeloid leukemia patients using autologous bone marrow transplantation and monoclonal antibody-purged bone marrow. Blood. 1994;83:1698-1705.
6. Foa R. Does interleukin-2 have a role in the management of acute leukemia? J Clin Oncol. 1993;11:1817-1825.