7+3

Say it: SEV-en plus THREE

Cytarabine and daunorubicin, sometimes with midostaurin

7+3 is a strong first treatment for acute myeloid leukemia (AML), given during a hospital stay to clear leukemia cells from the blood and bone marrow.

Also called: 7 plus 3, 7 and 3, seven plus three, cytarabine and daunorubicin, 7+3 with midostaurin, 7+3 with gemtuzumab, induction chemo for AML

What it is

The name comes from the schedule: 7 days of cytarabine and 3 days of daunorubicin. The two medicines kill leukemia cells in different ways, so together they work better. This first phase is called induction, and the goal is remission (no leukemia seen in the bone marrow). After remission, more treatment is needed to keep the leukemia away, such as more chemotherapy or a stem cell transplant.

Often used for

• New acute myeloid leukemia (AML) in people strong enough for intensive treatment
• FLT3 mutated AML, with midostaurin added

7+3 with midostaurin

Used when the leukemia has a FLT3 gene change. Midostaurin pills are added after the chemotherapy days and help people live longer.

7+3 with quizartinib

Another option for leukemia with a FLT3 gene change called FLT3 ITD. It is a daily pill added after the chemotherapy days.

7+3 with gemtuzumab ozogamicin

Used for some types of AML whose cells carry a marker called CD33, often lower risk types. It is an antibody linked to chemotherapy, given through a vein on a few days.

7+3 with idarubicin

Some centers use idarubicin in place of daunorubicin. It works in a similar way.

The medicines in this plan

Cytarabine

Chemotherapy that stops leukemia cells from copying their DNA. Given through a vein nonstop, all day and night, for 7 days.

Daunorubicin

An anthracycline chemotherapy (a red medicine). Given through a vein on days 1, 2 and 3.

Midostaurin

A targeted pill for leukemia with a FLT3 gene change. Taken twice a day with food, usually on days 8 to 21.

How you get it

7+3 is given in the hospital. You will usually stay about 3 to 5 weeks, until your blood counts recover enough to go home safely. A central line (a long tube placed in a large vein) is usually put in so medicines and blood can be given easily. A bone marrow test is often done around day 14 and again when counts recover. Your schedule may be different.

A typical cycle

Days 1 to 3

Cytarabine runs nonstop through your line. Daunorubicin is given through the line once each day.

Days 4 to 7

Cytarabine keeps running nonstop. Nausea medicines are given each day.

Days 8 to 21

Chemotherapy is done. If you have a FLT3 change, you take midostaurin pills twice a day. Blood counts drop very low, and you will likely need blood and platelet transfusions.

Around day 14

A bone marrow test may be done to see if leukemia cells are gone.

Days 21 to 35

Blood counts slowly recover. A bone marrow test checks for remission. You go home when it is safe.

Common side effects and what helps

• Very low blood counts. This raises the risk of infection, bleeding and tiredness. Wash hands often and ask visitors who are sick to stay away.
• Fever while your white blood cells are low. This is common and is treated right away with IV antibiotics in the hospital.
• Nausea and vomiting. Take the nausea medicines on schedule and ask for more if they are not working.
• Mouth sores. Rinse with a gentle salt and baking soda rinse and use a soft toothbrush.
• Hair loss, usually starting 2 to 3 weeks after treatment begins. It grows back after treatment ends.
• Diarrhea. Tell your nurse so it can be treated and checked for infection.
• Red or pink urine for a day or two after daunorubicin. This is the color of the medicine, not blood.
• Rash or red, itchy eyes from cytarabine. Eye drops may be used to help.
• Feeling very tired and weak. Short walks in the hallway help keep your strength up.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Bleeding that will not stop, nosebleeds, blood in urine or stool, or many new bruises
• Trouble breathing, chest pain, or a racing heartbeat
• New confusion, a very bad headache, or trouble with balance or speech
• Shaking chills or feeling faint when the IV line is flushed
• Redness, pain, swelling or pus around your central line
• After going home: any of the above, or you cannot eat or drink

Good to know

• You will stay in the hospital for most of this treatment, often 3 to 5 weeks.
• You will have blood tests every day and many blood and platelet transfusions.
• A heart test (echocardiogram or MUGA scan) is done before starting because daunorubicin can weaken the heart.
• Bone marrow tests show whether the leukemia is in remission.
• Medicines to prevent infection and tumor lysis syndrome (a problem when many leukemia cells break down quickly) are usually given.
• If you take midostaurin, tell your team about all your other medicines, since some can change its level.

At home

• Take your temperature if you feel unwell and call right away for a fever.
• Keep taking your infection prevention pills exactly as prescribed.
• Wash hands often, avoid crowds and people who are sick, and avoid gardening or cleaning litter boxes.
• Use a soft toothbrush and an electric razor to lower the chance of bleeding.
• Keep your central line dressing clean and dry, and follow your team's line care steps.
• Eat small meals often and drink plenty of fluids.

Questions to ask

• Does my leukemia have a FLT3 change or other gene changes that change my plan?
• How long will I likely be in the hospital?
• What happens after induction if I reach remission?
• Will I need a stem cell transplant?
• When will we know if the treatment worked?
• What can my family do to help prevent infections?

Leukemia

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.