OnCo
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7+3 induction chemotherapy

aka 7+3, 7 + 3, cytarabine-anthracycline, cytarabine plus daunorubicin, intensive chemotherapy, intensive induction, non-intensive, non-intensive therapy, less intensive, CPX-351, Vyxeos, HiDAC, high-dose cytarabine, FLAG-IDA

The classic first treatment for acute myeloid leukaemia, unchanged since 1973: seven days of continuous cytarabine plus three days of an anthracycline, given in hospital. Fit patients still get it, now with a targeted drug added according to their leukaemia's genetics.

7+3 achieves complete remission in 60-80% of younger adults and is followed by consolidation (high-dose cytarabine) or allogeneic transplant depending on ELN risk. Additions by genotype: midostaurin or quizartinib for FLT3 mutations, gemtuzumab ozogamicin for favourable-risk CD33-positive disease, CPX-351 (liposomal 7+3) for secondary AML. Patients unfit for intensive chemotherapy receive venetoclax plus azacitidine, which is eroding the boundary between 'intensive' and 'non-intensive' approaches. Induction mortality is 5-10% and the main risks are infection and bleeding during weeks of aplasia.

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