Mitoxantrone and high-dose cytosine arabinoside for the treatment of refractory acute lymphocytic leukemia

✍ Scribed by Hagop M. Kantarjian; Ronald L. Walters; Michael J. Keating; Elihu H. Estey; SUSAN O'Brien; Jay Schachner; Kenneth B. McCredie; Emil J Freireich

• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 447 KB
• Volume: 65
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19900101)65:1<5::aid-cncr2820650104>3.0.co;2-r

✦ Synopsis

Twenty-five adult patients with refractory acute lymphocytic leukemia received salvage therapy with mitoxantrone 5 mg/m2 intravenously over 1 hour daily for 5 days and cytosine arabinoside 3 g/m2 intravenously over 2 hours every 12 hours for six doses. Overall, nine patients (36%) achieved complete remission, eight (32%) died during induction, and eight (32%) had resistant disease. No significant associations were found between pretreatment patient characteristics and remission. Remission durations were short with a median of 9 weeks; the overall median survival was 10 weeks. The major dose-limiting toxic effects were related to myelosuppression. Febrile episodes requiring hospitalization occurred in 23 patients (92%), including five episodes of fever of unknown origin (20%) and 18 episodes of documented infections (72%). The authors conclude that the combination of mitoxantrone and high-dose cytosine arabinoside has significant activity in adults with refractory acute lymphocytic leukemia. The addition of colony-stimulating growth factors to the intensive chemotherapy, and the use of the combination regimen as part of front-line maintenance intensification therapy may further improve the prognosis in these patients.

Cancer 655-8, 1990.

CUTE LYMPHOCYTIC LEUKEMIA (ALL) is one form