Addition of Lomustine in the Treatment of Elderly Patients with Acute Myeloblastic Leukemia Improves Survival with Acceptably Increased Infectious Toxicity. a Filo Study

The LAMSA2007 trial of the French collaborative FILO group (Clinicaltrial.gov ID, NCT00590837) demonstrated the improvement of treatment results brought by the addition of lomustine for elderly (60 years old or more) fit patients with acute myeloblastic leukemia. Of 448 patients included, 222 received lomustine. Lomustine (200 mg/m² D1) was added to a standard induction (8mg/m² D1-5 idarubicin, 100 mg/m² D1-7 cytarabine) then to a consolidation schedule (8mg/m² D1-3 idarubicin, 50 mg/m² x2 D1-5 cytarabine subcut. with or without lomustine 80 mg D1) and 6 mini-reinductions (idarubicin 8 mg/m² D1 IV, cytarabine 50 mg/m²/12h D1-D5 with or without lomustine 40 mg D1), followed by a 6-months oral maintenance with 6-mercaptopurine and methotrexate.