Administering high-dose cytarabine to children with myeloid leukemia of Down syndrome (ML-DS) during the second chemotherapy induction cycle resulted in improved event-free survival (EFS) and overall survival (OS) compared to results observed in previous research studies.
In COG AAMO0431, researchers used the treatment schema from the prior COG A2971 trial with 3 major modifications:
- High-dose cytarabine with asparaginase was administered in induction II instead of intensification, thus replacing 1 of 4 cycles of continuous-infusion cytarabine and daunorubicin and reducing the cumulative daunorubicin dose by 25%.
- Intensification cycles with moderate-dose cytarabine and etoposide were administered instead of high dose cytarabine.
- The number of prophylactic intrathecal doses was reduced from 7 to 2.
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