Chemotherapy for adult acute nonlymphocytic leukemia with daunorubicin and cytosine arabinoside.

Fourteen of 21 adult patients (67%) with acute nonlymphocytic leukemia achieved a complete remission (CR) after receiving combination chemotherapy with daunorubicin and cytosine arabinoside (ara-C). Eight of the 14 CRs developed after a single course and four of 14 after two courses of induction therapy making initial hospitalization relatively brief (median, 38 days). Four of five patients greater than 60 years old achieved CR. The induction therapy was repeated monthly up to the dosage limits imposed by daunorubicin cardiotoxicity in an attempt to lengthen subsequent remission duration. The media duration of CR was 12 months which compares favorably with previously reported series. In this series, treatment with 3 days of daunorubicin and 7 days of ara-C proved to be a highly effective induction regimen for patients with acute nonlymphocytic leukemia regardless of age. The improved duration of CR may be a manifestation of the extent of initial leukemic cell-kill in successful induction and consolidation therapy rather than an effect of maintenance therapy cycles.