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The intensive chemotherapy that has induced remission in fit AML patients since 1973: seven days of one drug, three of another. Still the backbone that targeted drugs are added to.
Cytarabine 100-200 mg/m² continuous infusion for 7 days with daunorubicin 60-90 mg/m² or idarubicin 12 mg/m² for 3 days. Induces CR in 60-80% of younger adults. Modern practice adds midostaurin or quizartinib (FLT3), gemtuzumab (CD33+ favourable/intermediate risk), or uses CPX-351 (secondary AML). High-dose cytarabine consolidation follows. Five decades of incremental optimisation rather than replacement.
Cytarabine is a pyrimidine analogue that terminates DNA chain elongation; anthracyclines intercalate DNA and poison topoisomerase II.
1.Cytarabine is converted to ara-CTP inside blasts
Source: US prescribing information (DailyMed). Doses are for orientation; the current label governs.
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| Region | Year | Indication |
|---|---|---|
| US | 1969 | Cytarabine approved for acute leukaemia; 7+3 established 1973 |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Profound myelosuppression Expected; 2-4 weeks aplasia | 100% | - |
| Febrile neutropenia / infection | 80% | - |
| Induction mortality ~5% in younger fit adults, higher over 60 | - | - |
| Anthracycline cardiotoxicity Cumulative-dose dependent | - | - |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Cytarabine + anthracycline" OR ABSTRACT:"Cytarabine + anthracycline" OR TITLE:"'7+3'" OR ABSTRACT:"'7+3'") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Cytarabine + anthracycline ('7+3'), not a curated reading list.
Shares CPX-351 Study 301, Daunorubicin, Secondary and therapy-related acute myeloid leukaemia, Acute myeloid leukaemia in older or unfit patients.
Shares IDH1- and IDH2-mutated acute myeloid leukaemia, FLT3-mutated acute myeloid leukaemia, NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia, Secondary and therapy-related acute myeloid leukaemia.
Shares RATIFY (CALGB 10603), IDH1- and IDH2-mutated acute myeloid leukaemia, FLT3-mutated acute myeloid leukaemia, NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia.
Shares QuANTUM-First, FLT3 inhibitor + intensive chemotherapy, QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML, FLT3-mutated acute myeloid leukaemia.
Shares QuANTUM-First, RATIFY (CALGB 10603), QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML, Acute myeloid leukaemia.
Shares FLT3 inhibitor + intensive chemotherapy, RATIFY (CALGB 10603), QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML, FLT3-mutated acute myeloid leukaemia.
Shares IDH1- and IDH2-mutated acute myeloid leukaemia, FLT3-mutated acute myeloid leukaemia, NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia, Secondary and therapy-related acute myeloid leukaemia.
Shares IDH1- and IDH2-mutated acute myeloid leukaemia, FLT3-mutated acute myeloid leukaemia, NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia, Secondary and therapy-related acute myeloid leukaemia.