Amsacrine is safe and effective therapy for patients with myocardial dysfunction and acute leukemia

✍ Scribed by Zalmen A. Arlin; Eric J. Feldman; Abraham Mittelman; Tauseef Ahmed; Carmelo Puccio; Hoo G. Chun; Perry Cook; Paul Baskind; Charles Marboe; Rakesh Mehta

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 306 KB
• Volume: 68
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19910915)68:6<1198::aid-cncr2820680603>3.0.co;2-e

✦ Synopsis

The role of amsacrine in inducing remission in patients with cardiac disease and acute leukemia was evaluated. There were 17 patients with acute myelogenous leukemia (AML), six with acute lymphocytic leukemia (ALL), and one with biphenotypic leukemia. In this series of 24 patients whose disease had relapsed and who had reduced left ventricular ejection fraction, nine had a complete remission, seven with AML and two with ALL. In addition, four of six with newly diagnosed acute leukemia and reduced left ventricular ejection fraction also responded. Among nine patients who underwent endomyocardial biopsy, none had morphologic changes of sufficient degree to account for drug-induced heart failure. Patients with preexisting arrhythmias received amsacrine without incident if their serum potassium level was higher than 4.0 mEq/l at the time of drug administration. Amsacrine is safe and effective therapy for patients with acute leukemia and cardiac disease, Cancer 68:1198-1200,1991.

RADITIONAL THERAPY for acute myelogenous leu-T kemia (AML) includes daunorubicin and cytarabine in both induction and consolidation phases of thera ~y . ' -~

In some programs, both drugs are used for an extended period during the maintenance phase.6 In some patients, prolonged use of the traditional anthracyclines may cause heart failure from drug-induced cardiomyopathy.' Further treatment with anthracyclines in such cases is not possible, and other alternatives are required. Similarly, in patients with myocardial dysfunction from other causes, the anthracyclines may not be an ideal treatment.

We examined the results of therapy in a large series of patients with leukemia*-" who received amsacrine to evaluate the effect of this drug on myocardial function and its effectiveness in patients with myocardial dysfunc-