{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:06:58Z","timestamp":1780387618137,"version":"3.54.1"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82341213"],"award-info":[{"award-number":["82341213"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2026,6]]},"abstract":"ABSTRACT<\/jats:title>\n \n Daunorubicin dose optimization remains crucial for AML treatment. While 90\u2009mg\/m\n 2<\/jats:sup>\n benefits younger adults and 45\u2009mg\/m\n 2<\/jats:sup>\n remains standard for older patients, the optimal dose for patients aged 55\u201365\u2009years is unclear. We evaluated whether intermediate dose escalation to 60\u2009mg\/m\n 2<\/jats:sup>\n would improve outcomes compared to that of standard 45\u2009mg\/m\n 2<\/jats:sup>\n in this population. In this prospective, randomized, open\u2010label, single\u2010center trial, newly diagnosed AML patients aged 55\u201365\u2009years were randomly assigned 1:1 to receive daunorubicin 45\u2009mg\/m\n 2<\/jats:sup>\n (Group S) or 60\u2009mg\/m\n 2<\/jats:sup>\n (Group M) on days 1\u20133, combined with cytarabine for the induction. At median follow\u2010up of 35.9\u2009months, no significant difference in OS was observed between the two groups (HR 1.24, 95% CI 0.80\u20131.91;\n p<\/jats:italic>\n \u2009=\u20090.333). Median OS was 48.7\u2009months (95% CI 28.2\u2013NR) in Group S vs. 33.0\u2009months (95% CI 22.2\u201371.6) in Group M. Five\u2010year survival rates were comparable (45.2% vs. 39.8%). CR rates after first induction were equivalent (47.1% vs. 44.4%; RD +2.7%, 95% CI \u201317.4 to 12.0;\n p<\/jats:italic>\n \u2009=\u20090.720). MRD\u2010negative CR rates showed no difference (35.6% vs. 32.2%;\n p<\/jats:italic>\n \u2009=\u20090.632). RFS (HR 1.38, 95% CI 0.84\u20132.26;\n p<\/jats:italic>\n \u2009=\u20090.201) and EFS (HR 1.18, 95% CI 0.81\u20131.74;\n p<\/jats:italic>\n \u2009=\u20090.389) were similar in both arms. Regarding safety, while overall infection rates were similar, Group M showed a significantly higher incidence of documented intestinal infections compared to Group S (22.5% vs. 8.0%;\n p<\/jats:italic>\n \u2009=\u20090.011). Exploratory subgroup analyses revealed no consistent patterns favoring either strategy across clinical or molecular subgroups. Daunorubicin dose escalation from 45 to 60\u2009mg\/m\n 2<\/jats:sup>\n provides no clinical benefit but significantly increases mucosal toxicity. Therefore, 45\u2009mg\/m\n 2<\/jats:sup>\n should remain the preferred regimen for this population.\n <\/jats:p>\n \n Trial Registration:<\/jats:bold>\n ClinicalTrials.gov<\/jats:ext-link>\n identifier: NCT02432872\n <\/jats:p>","DOI":"10.1111\/cas.70383","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:20:29Z","timestamp":1776313229000},"page":"1690-1700","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Daunorubicin\u201045 Vs. Daunorubicin\u201060 for Induction in Intermediate\u2010Age Patients of\n AML<\/scp>\n : Results From a Randomized Trial"],"prefix":"10.1111","volume":"117","author":[{"given":"Chunlin","family":"Zhou","sequence":"first","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiqi","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuntao","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Lin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benfa","family":"Gong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangji","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyuan","family":"Gong","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyun","family":"Fang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingcheng","family":"Liu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3866-0066","authenticated-orcid":false,"given":"Shaowei","family":"Qiu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China"},{"name":"Tianjin Institutes of Health Science Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases Tianjin Key Laboratory of Cell Therapy for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.6.2086"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102005\u201009\u20103724"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0901409"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102011\u201006\u2010361410"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102015\u201001\u2010623447"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.72.8618"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.281045"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V60.2.454.454"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904544"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201003\u2010209262"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015850"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016867"}],"container-title":["Cancer Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cas.70383","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cas.70383","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cas.70383","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:18:48Z","timestamp":1780384728000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cas.70383"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/cas.70383"],"URL":"https:\/\/doi.org\/10.1111\/cas.70383","archive":["Portico"],"relation":{},"ISSN":["1347-9032","1349-7006"],"issn-type":[{"value":"1347-9032","type":"print"},{"value":"1349-7006","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"assertion":[{"value":"2025-10-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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