High-dose daunorubicin may benefit patients with acute myeloid leukemia (AML) with favorable and intermediate cytogenetics as well as FLT3-ITD, NPM1, and DNMT3A mutations, according to a study published in Blood.1

Researchers led by Marlise Luskin, MD, of the University of Pennsylvania in Philadelphia updated results from the initial report of the ECOG-ACRIN Cancer Research Group trial E1900 which found that induction therapy with high-dose daunorubicin improved overall survival in adults with AML who were younger than 60 years.

However, initial analysis found that the benefit was restricted to patients younger than 50 years as well as those without unfavorable cytogenetics or a FLT3-ITD mutation.

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With a median follow-up of 80.1 months, the researchers focused on the benefit of high-dose daunorubicin on common genetic subgroups.

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Compared with patients treated with standard-dose daunorubicin, those treated with a high dose were associated with a hazard ratio for death of 0.74. Patients younger than 50 years were found to benefit, as well as those with favorable and intermediate cytogenetics.

Upon multivariable analysis, patients with unfavorable cytogenetics were shown to benefit from high-dose daunorubicin, including those with FLT3-ITD, DNMT3A, and NPM1 mutations.


  1. Luskin MR, Lee J, Fernandez H, et al. Benefit of high dose daunorubicin in AML induction extends across cytogenetic and molecular groups: updated analysis of E1900 [published online ahead of print January 11, 2016]. Blood. doi: 10.1182/blood-2015-07-657403.