Reduced burden of infection with consecutive day dosing of high dose cytarabine consolidation versus conventional dosing for acute myeloid leukemia
Journal Title
Leukemia & Lymphoma
Publication Type
Online publication before print
Abstract
High-dose cytarabine given on days 1, 3, and 5 (HDAC-135) is a mainstay of consolidation treatment for acute myeloid leukemia (AML). Recent evidence indicates that consecutive daily dosing (HDAC-123) accelerates hematologic recovery and reduces hospitalization duration without compromising survival. However, the impact of HDAC-123 on infection outcomes is unclear. We performed a retrospective analysis of 73 AML patients undergoing HDAC consolidation, including 24 (33%) patients aged ≥60 years. Thirty-six patients received HDAC-135, and 37 received HDAC-123. HDAC-123 was associated with a shorter duration of neutropenia (8 versus 10 days, p < .001), fewer neutropenic infections (58% versus 79%, p = .02), and a reduced cumulative number of bacteremia episodes per patient (1.54 versus 3.30, p = .03), particularly from Gram-negative pathogens (1.22 versus 3.15, p = .003) compared to HDAC-135. HDAC-123 was well tolerated across all ages and demonstrated improvements in infection-related complications, supporting its use as a safe and effective consolidation strategy in AML.
Keywords
Acute myeloid leukemia; consolidation chemotherapy; high dose cytarabine; infection; neutropenic fever
Department(s)
Infectious Diseases; Haematology
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Creation Date: 2026-01-22 02:13:27
Last Modified: 2026-01-22 02:13:47
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