Selection of an anthracycline

In a systematic review and meta-analysis, 18 randomized controlled trials that included 6,755 patients assessed the use of idarubicin versus daunorubicin as part of induction chemotherapy.[14]

In a systematic review and meta-analysis, 18 randomized controlled trials that included 6,755 patients assessed the use of idarubicin versus daunorubicin as part of induction chemotherapy.[14]

The use of idarubicin led to improved outcomes, including overall survival (OS), when compared with daunorubicin (12 studies, 5,976 patients; hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.84−0.96; P = .0008). However, there was an increased risk of death during induction (14 studies, 6,349 patients; relative risk [RR], 1.18; 95% CI, 1.01−1.36; P = .03) and mucositis (five studies, 2,000 patients; RR, 1.22; 95% CI, 1.04−1.44; P = .02) with idarubicin as compared with daunorubicin. Moreover, the survival benefit for idarubicin was no longer present if a daunorubicin dose of at least 180 mg/m2 was used (four studies, 2,867 patients; HR, 0.91; 95% CI, 0.82−1.00; P = .06).

In a systematic review and meta-analysis, 18 randomized controlled trials that included 6,755 patients assessed the use of idarubicin versus daunorubicin as part of induction chemotherapy.[14]

In patients aged 60 years and younger, outcomes for those who received daunorubicin (90 mg/m2/dose, total induction dosing at 270 mg/m2) were superior to those who received more traditional dosing (45 mg/m2/dose; total dose = 135 mg/m2). The complete remission (CR) rate was 71% versus 57% (P < .001), and the median survival was 24 months versus 16 months (P = .003).[15]

In a systematic review and meta-analysis, 18 randomized controlled trials that included 6,755 patients assessed the use of idarubicin versus daunorubicin as part of induction chemotherapy.[14]

No randomized comparison data between daunorubicin at 270 mg/m2 and daunorubicin at 180 mg/m2, or between daunorubicin at 270 mg/m2 and idarubicin, are available.