Therapy of acute myelogenous leukemia: results of combination chemotherapy with cytarabine, daunorubicin and 6-mercaptopurine.
From 1984 to 1989, we treated 34 adult patients with acute myelogenous leukemia (AML) with cytarabine, daunorubicin and 6-mercaptopurine for remission induction chemotherapy. One or two courses of consolidation chemotherapy with the same regimen as induction chemotherapy were given subsequently. No maintenance chemotherapy or central nervous system prophylaxis was administered. These patients included 23 men and 11 women, and had a mean age of 39. Eight of them older than 60 years of age were defined as elder age group. The overall complete remission (CR) rate was 62% (21/34), with elder versus younger age group 12.5% (1/8) vs. 77% (10/26). In patients who got CR after chemotherapy (3 cases with bone marrow transplantation and 1 case with only one course of chemotherapy were excluded), the median remission duration was 8 months, the median survival was 11.4 months, and the 2-year survival rate was 13.8%. Five cases died of complication of chemotherapy (2 septic shock and 3 intracerebral hemorrhage), and four of them were older than 60 years of age. In conclusion, this combined chemotherapy was as effective as that reported in western literature in treating AML in terms of CR rate. However, the 2-year survival rate was lower. The toxicity was acceptable, but the dosages of daunorubicin should be reduced in patients older than 60 years of age. Accordingly, to obtain a better prognosis in treating AML, further therapeutic modalities, such as bone marrow transplantation, methods with higher sensitivity in detecting residual leukemic cells, and new effective drugs, are mandatory.
Ko
W S
WS
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, R.O.C.
Chen
L M
LM
Hwang
S H
SH
Chao
T Y
TY
Wang
C C
CC
Kao
W Y
WY
Lee
W C
WC
Hwang
W S
WS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D012074:Remission Induction
D003561:Cytarabine; D015122:Mercaptopurine; D003630:Daunorubicin