Daunorubicin versus aclarubicin in combination with cytarabine and thioguanine in elderly patients with acute nonlymphocytic leukemia, a preliminary report

SUMMARY Twenty‐three elderly patients with untreated acute nonlymphocytic leukaemia (ANLL) ranging in age from 61 to 84 yr were randomly allocated to treatment with either aclarubicin, cytarabine and thioguanine (TAA) or daunorubicin, cytarabine and thioguanine (TAD). Complete remission was achieved in 6/13 and 4/10 patients, respectively. There was no difference in the number of courses to complete remission between the two therapy protocols. There were 7 deaths during induction treatment in the TAA group and 3 in the TAD group, probably due to chemotherapy induced granulocytopenia with septicaemia. The haematological toxicity was comparable in complete responders of the two treatment arms. These data indicate that aclarubicin is an effective drug in ANLL and that older patients respond to intensive chemotherapy in a similar manner as younger patients with this disease. However, treatment related deaths are common and the need for equipotent but less toxic regimens is paramount. This is especially true for patients with signs of heart, lung, kidney and liver disease.