Korean J Hematol 1999; 34(3):

Published online September 30, 1999

© The Korean Society of Hematology

급성 골수성 백혈병 관해유도요법의 비교 및 예후불량인자의 분석

김현중, 이홍기, 안병훈, 김원석, 윤성수, 강원기, 박근칠, 박찬형, 양윤선, 김선희, 김선우, 박찬형

성균관대학교 의과대학 삼성서울병원 내과학교실,
성균관대학교 의과대학 삼성서울병원 임상병리학교실,
성균관대학교 의과대학 삼성서울병원 삼성생명과학연구소

Comparison between Daunorubicin and Idarubicin in Acute Myelocytic Leukemia Induction Therapy and the Analysis of Prognostic Factors

Hyun-Joong Kim, Hong, Ghi Lee, Byung, Hoon Ahn, Won Seog Kim, Sung Soo Yoon, Won Ki Kang, Keunchil Park, Chan Hyung Park, Yoon Sun Yang, Sun Hee Kim, Seonwoo Kim

Devision of Hematology, oncology, Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Department of Clinical Pathology, Samsung Medical Center, Korea
Biomedical research institute, Korea

Abstract

Background: Anthracycline is the most important chemotherapy drug of acute myelocytic leukemia(AML). It has been reported that idarubicin could have better complete remission(CR) rate than daunorubicin. However, it is not completely established concerning the effectiveness of idarubicin. There are many prognostic indicators of AML, however, many discrepancies still exist in prognostic indicators among each centers.
Method: We analzed initial CR rate of 39 AML patients treated with combination of cytarabine plus idarubicin or daunorubicin at Samsung Medical Center from April, 1995 to December, 1997. We subgrouped the patients according to age, sex, initial WBC count, status of initial CR, CD34, and chromosome. We analyzed the initial CR rate and long term survival of each subgroups.
Result: Initial CR rates of idatubicin and daunorubicin were 76.5% and 72.7%, respectively, The median survival days of 39 patients was 727±308.8 days. 1-year survival rate and 1-year event free survival rate were 64.2% and 59.6%, respectively. Patients who had failure of initial CR, old age(>60 years), and initial high WBC counts(>100,000/L) showed a statistically significant shorter survival in univariate analysis. However, we could not find the signigicant difference in the positivity of CD34 and chromosomal abnormalities.
Conclusion: The effectiveness of idarubicin may be equivalent to that of daunorubicin. Failure of initial CR, old age, and high WBC counts were regarded as a prognostic risk factors of AML. However, a more definitive characterization of prognostic factors is warranted in further prospective study.

Keywords AML, Idarubicin, Daunorubicin, Prognostic factor

Article

Korean J Hematol 1999; 34(3): 396-402

Published online September 30, 1999

Copyright © The Korean Society of Hematology.

급성 골수성 백혈병 관해유도요법의 비교 및 예후불량인자의 분석

김현중, 이홍기, 안병훈, 김원석, 윤성수, 강원기, 박근칠, 박찬형, 양윤선, 김선희, 김선우, 박찬형

성균관대학교 의과대학 삼성서울병원 내과학교실,
성균관대학교 의과대학 삼성서울병원 임상병리학교실,
성균관대학교 의과대학 삼성서울병원 삼성생명과학연구소

Comparison between Daunorubicin and Idarubicin in Acute Myelocytic Leukemia Induction Therapy and the Analysis of Prognostic Factors

Hyun-Joong Kim, Hong, Ghi Lee, Byung, Hoon Ahn, Won Seog Kim, Sung Soo Yoon, Won Ki Kang, Keunchil Park, Chan Hyung Park, Yoon Sun Yang, Sun Hee Kim, Seonwoo Kim

Devision of Hematology, oncology, Department of Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Department of Clinical Pathology, Samsung Medical Center, Korea
Biomedical research institute, Korea

Abstract

Background: Anthracycline is the most important chemotherapy drug of acute myelocytic leukemia(AML). It has been reported that idarubicin could have better complete remission(CR) rate than daunorubicin. However, it is not completely established concerning the effectiveness of idarubicin. There are many prognostic indicators of AML, however, many discrepancies still exist in prognostic indicators among each centers.
Method: We analzed initial CR rate of 39 AML patients treated with combination of cytarabine plus idarubicin or daunorubicin at Samsung Medical Center from April, 1995 to December, 1997. We subgrouped the patients according to age, sex, initial WBC count, status of initial CR, CD34, and chromosome. We analyzed the initial CR rate and long term survival of each subgroups.
Result: Initial CR rates of idatubicin and daunorubicin were 76.5% and 72.7%, respectively, The median survival days of 39 patients was 727±308.8 days. 1-year survival rate and 1-year event free survival rate were 64.2% and 59.6%, respectively. Patients who had failure of initial CR, old age(>60 years), and initial high WBC counts(>100,000/L) showed a statistically significant shorter survival in univariate analysis. However, we could not find the signigicant difference in the positivity of CD34 and chromosomal abnormalities.
Conclusion: The effectiveness of idarubicin may be equivalent to that of daunorubicin. Failure of initial CR, old age, and high WBC counts were regarded as a prognostic risk factors of AML. However, a more definitive characterization of prognostic factors is warranted in further prospective study.

Keywords: AML, Idarubicin, Daunorubicin, Prognostic factor

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