AML مقايسه نتايج دو روش درماني سيتارا بين با دوز بالا و با دوز استاندازد در فاز تحكيمي بيماران مبتلا به

A Comparison High- Dose versus standard- dose cytosine Arabinoside in Patients with Acute Myeliod leukemia in postremission phase

Back ground: Theres a trend toward using high dose cytarabine as a complementory regimen in post remission phase patients.the use of this regimen in different studies and its lack of use in iranian clinics.made us to design this study to compare the results of high dose cytarabine regimen versus standard high grade dose cytarabine regimen. Materials and Methods: A randomized controlled trial was conducted on 39 patients with AML. Patients with de-novo AML remission with received induction 7+3 regimen. Complete responders to induction therepy were randomized for post remission therapy between HDAC 3 gr / m for 4 days or 7+3 regimen with cytarabin 200 mg lm for 7 days and Dounorobicin at 45 mg/m/d for 3days. Patients with AML(M3) secondary AML or positive myelodysplastic history were excluded. The AML diagnosis was made by aspiration biopsy of the bone marrow and if 50% cellularity and more than 30% myeloblasts were detected in the samples the therapy would have started. Results: 19 out of 39 patients received HDAC and 20 standard 7+3 regimen. With a median follow-up of 36 months there was not Significant diffrence in overall between HDAC and 7+3 regimen. The Survival rate at 24 months was 10% (HDAC) versus 23% (7+3). Disease free Survival (DFS) was 11 months (HDAC) versus 14 months (7+3) and median survival was 14 months (HDAC) versus 19.8 months (7+3).no significant difference between the two groups was detected. Post remission therapy was not associated with a Significantly increased risk of hematologic,ocular,hepatic and neurologic toxicity. Conclusion:Although limited, current experience suggests that HDAC regimen maybe a feasible and safe consolidation therapy without significant toxicity. This study did not demonstrate an improvement in survival for HDAC regimen,however,further studies is needed and recommended.