|
|
 Previous Article | Table of Contents | Next Article 
Intensive sequential chemotherapy with mitoxantrone and continuous infusion
etoposide and cytarabine for previously treated acute myelogenous leukemia
E Archimbaud, V Leblond, M Michallet, C Cordonnier, P Fenaux, P Travade, F Dreyfus, J Jaubert, Y Devaux and D Fiere
Service d'Hematologie, Hopital Edouard Herriot, UFR Alexis Carrel, Lyon,
France.
Intensive sequential chemotherapy with mitoxantrone, 12 mg/m2/d on days 1
through 3, etoposide, 200 mg/m2/d as a continuous infusion on days 8
through 10, and cytarabine, 500 mg/m2/d as a continuous infusion on days 1
through 3 and 8 through 10 was administered to 72 patients aged less than
60 years with previously treated acute myelogenous leukemia (AML). Forty
patients had refractory AML (nonresponse to prior therapy, early first
relapse, or multiple relapse) and 32 had late first relapse. Sixty-one
percent of patients, with a 95% confidence interval (CI) ranging from 49%
to 72%, achieved complete remission (CR), including 45% (CI: 30% to 62%) of
refractory patients and 81% (CI: 64% to 93%) of late first relapse
patients. Twenty-nine percent of patients (CI: 19% to 41%) did not respond
to therapy and 10% (CI: 4% to 19%) died from therapy-related toxicity.
Median duration of aplasia was 30 days. Nonhematologic WHO grade 3 or more
toxicity included sepsis (57% of patients), vomiting (10%), mucositis
(35%), diarrhea (7%), skin rash (6%), and hyperbilirubinemia (11%).
Postinduction therapy was attempted in 36 of 44 CR patients: 16 of them
received a second course of the same regimen, 7 received maintenance
chemotherapy, 4 underwent autologous bone marrow transplantation (BMT), and
9 allogeneic BMT. At a median follow-up of 20 months, 23 of the 44 complete
remitters have relapsed, 1 to 14 months after achievement of CR, including
19 of 31 patients not undergoing BMT. Median survival is 7 months with 16%
(CI: 4% to 28%) projected survival at 47 months. Median disease-free
survival is 6 months with 21% (CI: 3% to 39%) of CR patients projected to
remain disease-free at 46 months. Twenty-six percent (CI: 13% to 43%) of
the evaluable patients who did not receive transplantation had inversion of
CR duration. Among patients younger than 50 years, there was no significant
difference in disease-free survival between patients receiving
postinduction chemotherapy and those receiving BMT. We conclude that this
chemotherapy regimen is highly efficient and could be used as first-line
therapy in young patients with AML.
Volume 77,
Issue 9,
pp. 1894-1900,
05/01/1991
Copyright © 1991 by The American Society of Hematology
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
S. de Botton, A. Fawaz, S. Chevret, H. Dombret, X. Thomas, M. Sanz, A. Guerci, J. San Miguel, J. de la Serna, A.M. Stoppa, et al.
Autologous and Allogeneic Stem-Cell Transplantation As Salvage Treatment of Acute Promyelocytic Leukemia Initially Treated With All-Trans-Retinoic Acid: A Retrospective Analysis of the European Acute Promyelocytic Leukemia Group
J. Clin. Oncol.,
January 1, 2005;
23(1):
120 - 126.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Castaigne, S. Chevret, E. Archimbaud, P. Fenaux, D. Bordessoule, H. Tilly, T. de Revel, M. Simon, B. Dupriez, M. Renoux, et al.
Randomized comparison of double induction and timed-sequential induction to a "3 + 7" induction in adults with AML: long-term analysis of the Acute Leukemia French Association (ALFA) 9000 study
Blood,
October 15, 2004;
104(8):
2467 - 2474.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
