Comparison of daunorubicin and daunorubicin-DNA complex in the treatment of acute nonlymphoblastic leukemia

Sixty consecutive patients, 15–60 years old, with ANLL were divided randomly into three groups for induction treatment with one of the following regimens: R1, daunorubicin (DNR) 1.5 mg/kg on day 1+ARA-C 2 mg/kg body weight on days 1–5; R2, DNR 1.5 mg/kg on days 1 and 2+ARA-C 2 mg/kg on days 4–8; R3, DNR-DNA complex 1.5 mg/kg on days 1 and 2+ARA-C 2 mg/kg on days 4–8. Maintenance treatment consisted of monthly courses of DNA 1.5 mg/kg (R1, R2) or DNR-DNA 1.5 mg/kg (R3) combined with ARA-C 1 mg/kg on days 1–5, alternating with thioguanine 2 mg/kg PO on days 1–5 combined with ARA-C 1 mg/kg IV on days 1–5. Fourteen patients of 20 went into complete remission with R1, 13 of 18 with R2, and 15 of 22 with R3. The overall remission frequency was 70% and there was no significant difference between the different groups. The median time in first remission and the median survival time were 300 and 510 days, respectively, with R1; 335 and 495 days with R2; and 295 and 677 days with R3. There was no statistically significant difference between the groups treated according to the different regimens concerning the time in first remission. Survival was slightly better with R3 than with R1. Treatment with the DNR-DNA complex caused less pronounced thrombocytopenia and fewer ‘minor’ cardiac abnormalities than treatment with free DNR in the same dosage schedule.