title: High doses of ara-C and m-AMSA in the treatment of refractory acute non lymphocytic leukemia.
abstract: From November, '85 to March, '87, 17 patients (12 males and 5 females, median 28 years) with resistant or relapsed ANLL received HiDAC (3 g/m2 c.i. 3 hs every 12 hs, day 1-4) + m-AMSA (100 mg/m2 i.v. day 5-7) as salvage therapy: 8/17 patients (47.1%) achieved CR, 7/17 (41.1%) were resistant and 2/17 (11.8%) died during induction; 8/10 relapsed patients achieved a 2nd CR, while all 7 primary resistant patients failed to. Median period of PMN less than 0.5 x 10(9)/l was 28 days, median period of PLTS less than 30 x 10(9)/l was 25 days. All patients had infections during aplasia. Median CR duration was 6.6 months, while median survival of responders was 10.6 months. Two patients with severe induction-related complications relapsed after 2 and 5 months, respectively: 1 patient underwent BMT and relapsed after 21 months; 5 patients, 4 of whom had received a prior ABMT during 1st CR, underwent ABMT: 3 died from ABMT related toxicity and 2 relapsed after 8 and 18 months, respectively. We conclude that HiDAC + m-AMSA is highly effective in relapsed, but not in resistant patients with acceptable hematologic and extra-hematologic toxicity. The role and modalities of ABMT in prolonging a 2nd CR are at present controversial.
authors.affiliation: Dipartimento di Biopatologia Umana, Università La Sapienza, Roma, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Latagliata
authors.forename: M C
authors.initials: MC
authors.lastname: Petti
authors.forename: M A
authors.initials: MA
authors.lastname: Spiriti
authors.forename: G
authors.initials: G
authors.lastname: Meloni
authors.forename: C
authors.initials: C
authors.lastname: Sgadari
authors.forename: C
authors.initials: C
authors.lastname: Torromeo
authors.forename: M L
authors.initials: ML
authors.lastname: Vegna
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000677:Amsacrine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D000677:Amsacrine; D003561:Cytarabine