Treatment of patients with recurrent and primary refractory acute myelogenous leukemia using mitoxantrone and intermediate-dose cytarabine : A pharmacologically based regimen

✍ Scribed by David W. Sternberg; William Aird; Donna Neuberg; Lynn Thompson; Kimberly MacNeill; Philip Amrein; Lawrence N. Shulman

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 69 KB
• Volume: 88
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/(sici)1097-0142(20000501)88:9<2037::aid-cncr8>3.0.co;2-k

✦ Synopsis

BACKGROUND.

Although chemotherapy can achieve a high rate of disease remission induction in patients with newly diagnosed acute myelogenous leukemia (AML), patients with recurrent or refractory AML generally have a poorer rate of response. This study assessed the utility of mitoxantrone and intermediate-dose cytarabine (Ara-C) in the treatment of patients with recurrent or refractory AML.

METHODS.

Forty-seven patients with recurrent or refractory AML were treated with Ara-C, 0.5 gm/m 2 , intravenously (i.v.) every 12 hours ϫ 12 doses on Days 1-6 and mitoxantrone, 5 mg/m 2 , i.v. on Days 1-5.

RESULTS.

Twenty-nine of the 47 patients (62%) achieved a complete response. The median duration of disease remission was 112 days (range, 29 days-8 years). Of the 25 patients age Ն 60 years, 19 (76%) had a complete disease remission and the median duration of disease remission in this group was 114 days (range, 33-370 days), although all patients subsequently developed a disease recurrence. The chemotherapy generally was well tolerated, with a mean duration of neutropenia of 31 days and a mean duration of thrombocytopenia of 33 days. Three patients died of infectious complications between 23-26 days after the initiation of chemotherapy, 1 patient died of sudden cardiac arrest 13 days after the initiation of chemotherapy, and 1 patient developed cutaneous desquamation. Three patients developed acute cerebellar dysfunction.

CONCLUSIONS.

The use of mitoxantrone and Ara-C is effective in the treatment of patients with recurrent and refractory AML. The subgroup of patients age Ն 60 years also had a high rate of disease remission induction with this regimen, and the regimen generally was well tolerated.