daunorubicin + cytarabine + cladribine

DAC is a chemotherapy induction regimen consisting of three active ingredients: daunorubicin, cytarabine (Ara-C), and cladribine. It was specifically developed and studied by the Polish Adult Leukemia Group (PALG) for the treatment of newly diagnosed acute myeloid leukemia (AML) in adults. The regimen combines the DNA-intercalating and topoisomerase II-inhibiting properties of daunorubicin with the antimetabolite effects of cytarabine. Cladribine, a purine nucleoside analog, is included to potentiate the activity of cytarabine by increasing the intracellular concentration of its active triphosphate metabolite (ara-CTP). Clinical trials, such as the Phase 3 PALG-AML1/2016 study (NCT03257241), have compared DAC to other induction therapies like high-dose daunorubicin plus cytarabine (DA-90). While earlier PALG trials demonstrated improved complete remission and overall survival rates compared to standard DA-60 induction, recent topline results from the PALG-AML1/2016 trial indicated equivalent outcomes between the DAC and DA-90 regimens.

Other names

DAC regimenDAC inductionDAC-Polish Adult Leukemia Group-acute myeloid leukemia