High dose intermittent ARA-C (HiDAC) for consolidation of patients with de novo AML: a single center experience

High dose intermittent ARA-C (2 × 3 g/m2 i.v., days 1, 3, 5) = HiDAC was introduced as consolidation in AML by the CALGB-group in 1994. We treated 44 de novo AML patients in CR with up to four cycles of HiDAC (four cycles: 56.8%; three cycles: 22.7%; two cycles: 6.8%; one cycle: 13.7%). Median duration of aplasia (ANC < 0.5 × 109/l) was 12 days. Neutropenic fever occurred in 38.6% of the patients during the first, 52.6% during the second, 45.7% during the third, and in 40% during the fourth cycle. Non-hematologic toxicity was tolerable. The median overall- and disease-free survival were 19.3 and 11.3 months, respectively. The best outcome was seen in patients aged <40 years. These results confirm that HiDAC is a safe and effective consolidation in AML.