According to current recommendations, older AML patients in first complete remission (CR) after induction chemotherapy should receive consolidation with intermediate‐dose cytarabine (IDAC). However, no study has demonstrated the superiority of IDAC over other regimen. In this retrospective study, we compared the efficacy of mini‐consolidations (idarubicin 8 mg/m2 day 1, cytarabine 50 mg/m2/12 h, day 1–5) and IDAC. Inclusion criteria were newly diagnosed AML, age > 60 years, first CR after induction and at least 1 cycle of consolidation. Of the 796 included patients, 322 patients received mini‐consolidations and 474 patients received IDAC. Mini‐consolidation patients were older, and more often, they had de novo AML and unfavorable risk. The rate of allogeneic transplantation was higher in the IDAC group. The median number of cycles was higher in the mini‐consolidation group (4 vs. 2; p < .0001). Median relapse‐free survival was 18 months with mini‐consolidations and 12 months with IDAC (p = .0064). In multivariate analysis, the risk of relapse or death was significantly higher in the IDAC group (p = .004). Median OS was 36 versus 31 months with mini‐consolidations or IDAC, respectively (p = .46). In multivariate analysis, the consolidation regimen had no significant influence on OS (p = .43). In older AML patients, post‐remission therapy with mini‐consolidations represents an alternative to IDAC.

中文翻译：

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小型巩固或中等剂量阿糖胞苷用于 60 岁以上 AML 患者的缓解后治疗。来自 DATAML 和 SAL 注册管理机构的回顾性研究


根据目前的建议，诱导化疗后首次完全缓解 （CR） 的老年 AML 患者应接受中等剂量阿糖胞苷 （IDAC） 的巩固治疗。然而，没有研究证明 IDAC 优于其他方案。在这项回顾性研究中，我们比较了小巩固治疗 （伊达比星 8 mg/m2 第 1 天，阿糖胞苷 50 mg/m2/12 小时，第 1-5 天）和 IDAC 的疗效。纳入标准为新诊断的 AML、年龄 > 60 岁、诱导后首次 CR 和至少 1 个巩固周期。在纳入的 796 例患者中，322 例患者接受了小型巩固治疗，474 例患者接受了 IDAC。小型巩固治疗患者年龄较大，更常见的是新发 AML 和不良风险。IDAC 组的同种异体移植率较高。小型巩固组的中位循环数较高 （4 vs. 2;p < .0001）。小型整合的中位无复发生存期为 18 个月，IDAC 的中位无复发生存期为 12 个月 （p = .0064）。在多变量分析中，IDAC 组的复发或死亡风险显着更高 （p = .004）。小型整合或 IDAC 的中位 OS 分别为 36 个月和 31 个月 （p = .46）。在多变量分析中，巩固方案对 OS 没有显着影响 （p = .43）。在老年 AML 患者中，缓解后小巩固治疗是 IDAC 的替代方案。