title: AMSA combination chemotherapy in patients with acute myelogenous leukemia unsuitable for standard antileukemic treatment.
abstract: Forty-eight patients with acute myelogenous leukemia (AML) not eligible for anthracycline or mitoxantrone treatment, mostly due to cardiac contraindications, were given aggressive therapy using m-amsacrine (AMSA) in combination with conventional or high-dose cytarabine for remission induction. Twenty-nine patients (60.4%) responded to treatment, and complete remission was attained in 19 (39.6%), partial remission in 4 (8.3%) and death in bone marrow aplasia without detectable blasts in 6 patients (12.5%). Median time to granulocyte recovery was 32 days, median duration of relapse-free survival 199 days. One patient experienced a serious cardiac adverse event; nausea and vomiting were observed in 73%, diarrhea in 44%, and hepatoxicity in 29% of patients. All potentially AMSA-related side effects were fully reversible, and a lethal complication did not occur. It is concluded that combination chemotherapy with AMSA and Ara-C is also effective and tolerable in leukemic patients in whom cardiotoxic drugs are contraindicated.
authors.affiliation: Department of Internal Medicine, Hematology and Oncology, Evangelisches Krankenhaus Essen-Werden, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Maschmeyer
authors.forename: K
authors.initials: K
authors.lastname: Willborn
authors.forename: W
authors.initials: W
authors.lastname: Heit
mesh_terms: D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D015479:Leukemia, Myelomonocytic, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D016019:Survival Analysis; D013866:Thioguanine / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000677:Amsacrine; D003561:Cytarabine; D013866:Thioguanine