title: 13-cis-retinoic acid in the treatment of elderly patients with acute myeloid leukemia. A phase II pilot study of the Eastern Cooperative Oncology Group.
abstract: The management of acute myeloid leukemia in the elderly (65 years and older) is unsatisfactory because of poor patient tolerance of standard myeloablative chemotherapy. The authors conducted a Phase II study to evaluate the effectiveness and toxicity of 13-cis-retinoic acid (CRA) in the therapy of elderly patients with acute myeloid leukemia (AML). Patients presenting with leukocyte counts less than 20,000/microliters were treated with CRA alone. Those with leukocyte counts of 20,000/microliters or greater were pretreated with hydroxyurea, followed by CRA. Twelve of 18 patients received at least 4 weeks of CRA and were thus considered evaluable for toxicity and response. No objective responses were observed. Cis-retinoic acid administration was well tolerated; only modest dermatologic, musculoskeletal, and gastrointestinal toxicity was observed. Alternative therapeutic strategies should be investigated in this subpopulation of AML patients.
authors.affiliation: University of Rochester Cancer Center, New York.
authors.forename: Z B
authors.initials: ZB
authors.lastname: Kramer
authors.forename: L
authors.initials: L
authors.lastname: Boros
authors.forename: P H
authors.initials: PH
authors.lastname: Wiernik
authors.forename: J
authors.initials: J
authors.lastname: Andersen
authors.forename: J M
authors.initials: JM
authors.lastname: Bennett
authors.forename: P
authors.initials: P
authors.lastname: Cassileth
authors.forename: M
authors.initials: M
authors.lastname: Oken
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004341:Drug Evaluation; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality; D007958:Leukocyte Count; D010865:Pilot Projects; D015996:Survival Rate; D014212:Tretinoin / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D014212:Tretinoin; D006918:Hydroxyurea