# Cytarabine + anthracycline ('7+3')

Source: https://onco.cc/drugs/cytarabine-7-3/  
OnCo record `cytarabine-7-3` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

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.

## Summary

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.

## Fields

- Kind: Treatment
- Status: standard-of-care
- Last checked: 2026-09-07
- Modality: Cytotoxic regimen
- Mechanism: Cytarabine is a pyrimidine analogue that terminates DNA chain elongation; anthracyclines intercalate DNA and poison topoisomerase II.
- Approvals: US 1969: Cytarabine approved for acute leukaemia; 7+3 established 1973
- Dosing: IV; Cytarabine 100-200 mg/m²/day continuous infusion days 1-7; daunorubicin 60-90 mg/m² or idarubicin 12 mg/m² days 1-3

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Cytarabine
- Wikipedia: https://en.wikipedia.org/wiki/Cytarabine

## Connected records

- cancers: [Acute lymphoblastic leukaemia](https://onco.cc/cancers/all-leukemia/), [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Acute myeloid leukaemia in older or unfit patients](https://onco.cc/cancers/aml-older-unfit/), [Chronic myeloid leukaemia, accelerated and blast phase](https://onco.cc/cancers/cml-advanced-phase/), [FLT3-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-flt3/), [IDH1- and IDH2-mutated acute myeloid leukaemia](https://onco.cc/cancers/aml-idh/), [NPM1-mutated and KMT2A-rearranged acute myeloid leukaemia](https://onco.cc/cancers/aml-npm1-kmt2a/), [Secondary and therapy-related acute myeloid leukaemia](https://onco.cc/cancers/aml-secondary/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- trials: [ALFA-0701](https://onco.cc/trials/alfa-0701/), [COG AAML0531](https://onco.cc/trials/aaml0531/), [CPX-351 Study 301](https://onco.cc/trials/cpx-351-301/), [Inter-B-NHL Ritux 2010](https://onco.cc/trials/inter-b-nhl-ritux-2010/), [QuANTUM-First](https://onco.cc/trials/quantum-first/), [RATIFY (CALGB 10603)](https://onco.cc/trials/ratify/)
- pairings: [Blinatumomab added to frontline chemotherapy](https://onco.cc/pairings/blinatumomab-frontline-consolidation/), [FLT3 inhibitor + intensive chemotherapy](https://onco.cc/pairings/flt3i-plus-7-3/)
- key papers: [QuANTUM-First: quizartinib added to intensive chemotherapy and continued as maintenance in newly diagnosed FLT3-ITD AML](https://onco.cc/key-papers/paper-quantum-first-quizartinib-lancet-2023/)
- drugs: [Cytarabine](https://onco.cc/drugs/cytarabine/), [Daunorubicin](https://onco.cc/drugs/daunorubicin/)

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