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Home > LEU AML - cytarabine 3 g/m2 [days 1,2,3] consolidation [courses 3 and 4] [under 60 years]

LEU AML - cytarabine 3 g/m2 [days 1,2,3] consolidation [courses 3 and 4] [under 60 years]

Treatment Overview

Follows course 2 of induction treatment.

Frequency: Every 28 days or on count recovery.

Cycles 1 to 2 - 28 days - Courses 3 and 4

Cycle length:
28

Cycle details

Cycles 1 to 2 - 28 days - Courses 3 and 4

Medication Dose Route Days Max Duration
cytarabine 3000 mg/m² Twice daily intravenous 1, 2, 3 4 hours
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye 1 to 5
pegFILGRASTIM 6 mg subcutaneous injection 5

Full details

Cycles 1 to 2 - 28 days - Courses 3 and 4

Day: 1

Medication Dose Route Max duration Details
cytarabine 3000 mg/m² Twice daily intravenous 4 hours
Instructions:

Every 12 hours.
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 2

Medication Dose Route Max duration Details
cytarabine 3000 mg/m² Twice daily intravenous 4 hours
Instructions:

Every 12 hours.
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 3

Medication Dose Route Max duration Details
cytarabine 3000 mg/m² Twice daily intravenous 4 hours
Instructions:

Every 12 hours.
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 4

Medication Dose Route Max duration Details
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.

Day: 5

Medication Dose Route Max duration Details
prednisolone acetate 1% (10 mg/mL) eye drops * 1 Drop Every four hours application to the eye
Instructions:

Instil ONE drop into each eye every FOUR hours on days 1 to 5.
pegFILGRASTIM 6 mg subcutaneous injection

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis recommended
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Medium
Growth factor support: Recommended for primary prophylaxis
Ocular toxicity risk: High - administer corticosteroid eyedrops to minimise corneal toxicity
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: guidance is limited to high-risk anti-cancer medicines.  Clinicians will need to assess individual patient risk for other anti-cancer medicines.

Tumour lysis syndrome prophylaxis: Required if patient is not in complete remission.

References

Burnett, A. K., N. H. Russell, R. K. Hills, et al. 2013. "Optimization of chemotherapy for younger patients with acute myeloid leukemia: results of the medical research council AML15 trial." J Clin Oncol 31(27):3360-3368., PMID: 23940227

Jaramillo, S., A. Benner, J. Krauter, et al. 2017. "Condensed versus standard schedule of high-dose cytarabine consolidation therapy with pegfilgrastim growth factor support in acute myeloid leukemia." Blood Cancer J 7(5):e564., PMID: 28548643

Dumas, P. Y., S. Bertoli, E. Berard, et al. 2020. "Delivering HDAC over 3 or 5 days as consolidation in AML impacts health care resource consumption but not outcome." Blood Adv 4(16):3840-3849. , PMID: 32790847

Sperr, W. R., M. Piribauer, F. Wimazal, et al. 2004. "A novel effective and safe consolidation for patients over 60 years with acute myeloid leukemia: intermediate dose cytarabine (2 x 1 g/m2 on days 1, 3, and 5)." Clin Cancer Res 10(12 Pt 1):3965-3971., PMID: 15217926

Mayer, R. J., R. B. Davis, C. A. Schiffer, et al. 1994. "Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B." N.Engl.J.Med. 331(14):896-903., PMID: 8078551

AML17 trial protocol Version 10.2 dated June 2019

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.