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Mitoxantrone and 5-azacytidine for refractory/relapsed ANLL or CML in blast crisis: A leukemia intergroup study

✍ Scribed by Jack Goldberg; Jeff Gryn; Azra Raza; John Bennett; George Browman; John Bryant; Hans Grunwald; Richard Larson; Ralph Vogler; Harvey Preisler


Publisher
John Wiley and Sons
Year
1993
Tongue
English
Weight
406 KB
Volume
43
Category
Article
ISSN
0361-8609

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✦ Synopsis


In an effort to determine if cell cycle active agents are augmented when given after non-cell cycle active agents, 104 patients with either multiply relapsed or refractory acute nonlymphocytic leukemia or blast crisis of chronic myelogenous leukemia were treated with mitoxantrone. Patients whose bone marrow did not show significant cytoreduction received 5-aracytidine. Twenty-seven of the 93 evaluable patients (23%) with ANLL achieved a complete remission. A total of 28% of patients receiving mitoxantrone alone achieved remission compared to 15% for those receiving mitoxantrone and 5-azacytidine.

Relapsed patients had a higher CR rate (36%) than refractory patients (15%). Nausea, vomiting, and stomatitis were common but rarely severe. The median duration of remission was 3.7 months and patients with abnormal karyotypes had longer remission durations than those with normal karyotypes. In this patient population, there was no evidence that 5-azacytidine given after mitoxantrone increased the complete remission rate.