Liposomal Daunorubicin Improves Outcomes for Subgroup of Children’s AML

Children with acute myeloid leukemia (AML) that has the genetic t(8;21) translocation appear to achieve improved outcomes with the use of the chemotherapy agent liposomal daunorubicin compared to idarubicin as initial therapy. These results were recently published in the journal Blood.

Acute myeloid leukemia is a type of cancer that starts in the blood cells. It is considered an aggressive type of leukemia that requires intensive therapy for chances of a cure.

A subgroup of patients with AML have what is referred to as t(8;21) translocation – a genetic mutation that can be tested from blood samples. These patients may respond differently to different therapies; therefore, researchers continue to evaluate ways in which to improve outcomes for patients with different disease characteristics.

A major issue with treating leukemia is the long-lasting effects that the aggressive therapy may have on patients. For example, the chemotherapy class of agents referred to as anthracyclines often causes damage to the heart which has the potential to result in long-term medical issues.

Liposomal daunorubicin is an anthracycline that is encapsulated in a liposomal coating which reduces its exposure to healthy cells in the body when compared to standard anthracyclines.

Researchers from Europe recently conducted a clinical trial to compare liposomal daunorubicin to another anthracycline, idarubicin, commonly used in the treatment of AML. The trial included 521 pediatric patients with AML who were treated with intensive doses of either liposomal daunorubicin or idarubicin as initial (induction) therapy.

Among patients with t(8;21), those treated with liposomal daunorubicin had a significantly improved survival without adverse events than those treated with idarubicin.
Overall, 5-year results of outcomes were similar between the two treatment groups.
Treatment-related mortality was lower among the group of patients treated with liposomal daunorubicin than those treated with idarubicin.
The researchers concluded that liposomal daunorubicin appears to be an effective substitute for idarubicin as initial therapy for pediatric patients with AML. Furthermore, it appears that liposomal daunorubicin is highly effective in the subgroup of patients with t(8;21).

Reference: Creutzig U, Zimmermann M, Bourquin J-P, et al. Randomized trial comparing liposomal daunorubicin with idarubicin in induction for pediatric acute myeloid leukemia: results from Study AML-BFM 2004. Blood. Published online before print May 23, 2013, doi: 10.1182/blood-2013-02-484097.