AML

Induction:

The “3+7 regimen”: anthracycline (ie, IDA or daunorubicin [DNR]) daily for 3 days + ara-C given at 100 to 200 mg/m2 daily for 7 days by continuous infusion

Consolidation:

HDAC (1-3 g/m2)

• The toxicity of HDAC (eg, cerebellar) outweighs the anti-AML effect in patients >65 years;
• Patients >60 years benefit from HDAC given during induction (SWOG, ALSG), in CR (CALGB, ECOG), and perhaps both (SWOG)
• HDAC potentially increases the cure rates to 70% to 80% in patients with inversion 16 or t(8;21) and to 30% to 40% in patients with normal karyotype, but little, if at all, in patients with adverse karyotypes

Relapsed/refractory:

ID-FLAG

Idarubicin 10 mg/m2 IV daily days 1-3 + fludarabine 30 mg/m2 IV days 1-5 + cytarabine 2 g/m2 (over 4 hours starting 4 hours after fludarabine) days 1-5 + G-CSF SC daily days 0-14

HDAC-IDA

Cytarabine 3 g/m2 q12h days 1,3,5 + idarubicin 12 mg/m2 IV daily days 1-3

MEC

Mitoxantrone 8 mg/m2 days 1-5 + etoposide 100 mg/m2 days 1-5 + cytarabine 1 g/m2 q12h days 1-5

APL