Treatment of relapsed and refractory acute leukaemia with high-dose cytosine arabinoside and etoposide

✍ Scribed by Martin Gore; Ray Powles; Anil Lakhani; Sarah Milan; Jennifer Maitland; Glen Goss; Ann Nandi; Timothy Perren; Garry Forgeson; Jennifer Treleaven; Ayed Zuiable; Fulvio Porta

• Publisher: Springer
• Year: 1989
• Tongue: English
• Weight: 425 KB
• Volume: 23
• Category: Article
• ISSN: 0344-5704
• DOI: 10.1007/bf00435839

✦ Synopsis

A total of 65 patients under the age of 55 with acute leukaemia received high-dose cytosine arabinoside (Ara-C) in combination with high-dose etoposide without an anthracycline. Complete remission rates for patients with relapsed or refractory acute myelogenous leukaemia (AML) were 15/25 (60%) and 11/16 (69%), respectively. The complete remission rate for patients with refractory or relapsed acute lymphoblastic leukaemia (ALL) was 10/18 (56%). The treatment-related mortality was 17%. Nine patients whose leukaemia relapsed after matched allogeneic, sibling bone-marrow transplantation (BMT) were also treated in this way; the treatment-related mortality in this group was high (7/9) and the duration of remission in the two patients who responded, too short to justify this intensive treatment in such patients. Similarly, patients who underwent BMT after achieving a complete remission with high-dose Ara-C and etoposide did very poorly, only one patient surviving well and disease-free at 8 months. The important finding in this study was the high complete remission rate rapidly obtained in patients with relapsed or refractory AML without using an anthracycline.