Remission Induction

The goal of induction chemotherapy in AML is essentially identical to that in ALL: "Empty" the bone marrow of all hematopoietic precursors, and allow repopulation with normal cells. The combination of an anthracycline (e.g., daunorubicin, doxoru-bicin, or idarubicin) and the antimetabolite cytarabine forms the backbone of AML induction therapy. The most common induction regimen (7 + 3) combines daunorubicin for 3 days with cytarabine on days 1 to 7. The remission rate for this combination is approximately 80% in children and younger adults but declines to 40% to 50% in patients older than 60 years of age.6 Despite studies that have used alternative anthra-cyclines or substituted high-dose for conventional-dose cytarabine and added etopos-ide and/or thioguanine, the 7 + 3 regimen remains the standard induction regimen.

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