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Meta-Analysis of Randomised Clinical Trials Comparing Idarubicin + Cytarabine with Daunorubicin + Cytarabine as the Induction Chemotherapy in Patients with Newly Diagnosed Acute Myeloid Leukaemia

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Listed:
  • Jing Wang
  • Yong-Gong Yang
  • Min Zhou
  • Jing-Yan Xu
  • Qi-Guo Zhang
  • Rong-Fu Zhou
  • Bing Chen
  • Jian Ouyang

Abstract

Background: To determine whether the use of idarubicin+cytarabine (IA) is more effective than the use of daunorubicin+cytarabine (DA) as induction chemotherapy for patients with newly diagnosed acute myeloid leukaemia. Methods: A computer-based search was performed. Randomised trials comparing IA with DA as induction therapy for newly diagnosed AML were included in this meta-analysis. The primary outcome of interest for our analysis was survival (disease-free survival, event-free survival and overall survival); the secondary endpoint was complete remission. Results: Ten trials with 4,060 patients were eligible for this meta-analysis. Our pooled results suggest that IA is associated with a significant advantage in CR (RR = 1·23; 95% CI = 1·07–1·41, p = 0.004), EFS (HR = 0·64; 95% CI = 0·45–0·91, p = 0.013), and OS (HR = 0·88; 95% CI = 0·81–0·95, p = 0.02) but not in DFS (HR = 0·90; 95% CI = 0·80–1·00, p = 0.06). In the subgroup analysis, age had a significant interaction with OS and CR benefits. Conclusion: Our analysis indicated that IA could improve the duration of overall survival compared to DA as induction therapy for young patients with newly diagnosed AML. Further study is needed to determine whether IA can produce clinical benefits in selected genetic or molecular subgroups of young AML patients.

Suggested Citation

  • Jing Wang & Yong-Gong Yang & Min Zhou & Jing-Yan Xu & Qi-Guo Zhang & Rong-Fu Zhou & Bing Chen & Jian Ouyang, 2013. "Meta-Analysis of Randomised Clinical Trials Comparing Idarubicin + Cytarabine with Daunorubicin + Cytarabine as the Induction Chemotherapy in Patients with Newly Diagnosed Acute Myeloid Leukaemia," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-9, April.
    • Handle: RePEc:plo:pone00:0060699
    DOI: 10.1371/journal.pone.0060699
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    References listed on IDEAS

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    1. Colin B. Begg & Jesse A. Berlin, 1988. "Publication Bias: A Problem in Interpreting Medical Data," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 151(3), pages 419-445, May.
    2. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    Cited by:

    1. Alvarado Ibarra Martha & Guerra Alarcón Lidia Virginia & Mena Zepeda Verónica & Ortiz Zepeda Maricela & Espitia Ríos Eugenia & à lvarez Vera José Luis & De la Peña Celaya Antonio & López Hernán, 2018. "Frontline Treatment of Acute Myeloid Leukemia in Adults Long-Term Results in a Mexican Medical Center," Cancer Therapy & Oncology International Journal, Juniper Publishers Inc., vol. 10(5), pages 86-94, May.
    2. Qiang Gong & Lixin Zhou & Shuangnian Xu & Xi Li & Yunding Zou & Jieping Chen, 2015. "High Doses of Daunorubicin during Induction Therapy of Newly Diagnosed Acute Myeloid Leukemia: A Systematic Review and Meta-Analysis of Prospective Clinical Trials," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-14, May.

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