title: Successful treatment of adult acute lymphoblastic leukemia after relapse with prednisone, intermediate-dose cytarabine, mitoxantrone, and etoposide (PAME) chemotherapy.
abstract: Thirty-nine patients with relapsed acute lymphoblastic leukemia (ALL) and four with primarily refractory ALL were treated with a regimen that included cytarabine 1 gm/m2 (2-hour infusion) twice daily days 1 to 5, mitoxantrone 12mg/m2 daily days 1 to 5, prednisone 0.5 mg/kg daily days 1 to 5, and etoposide 200 mg/m2/day daily days 6 to 8. Of the 43 patients, 30 achieved a complete remission (CR), 28 out of the 39 relapsed patients and two among the four with refractory disease. Five patients died in aplasia. Eight patients were nonresponders. Nonhematologic side effects consisted predominantly of nausea, vomiting, and mucositis. One patient had transient cerebellar dysfunction. Recovery of blood counts occurred at a median of 24 days. The median time to CR was 38 days. As this regimen is highly effective in relapsed or refractory ALL, its use during earlier stage of the disease is warranted.
authors.affiliation: Department of Hematology, C.H.U. Nantes, France.
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.forename: C
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: J L
authors.initials: JL
authors.lastname: Harousseau
authors.forename: C
authors.initials: C
authors.lastname: Sebban
authors.forename: F
authors.initials: F
authors.lastname: Witz
authors.forename: X
authors.initials: X
authors.lastname: Troussard
authors.forename: N
authors.initials: N
authors.lastname: Gratecos
authors.forename: M
authors.initials: M
authors.lastname: Michallet
authors.forename: V
authors.initials: V
authors.lastname: LeBlond
authors.forename: G
authors.initials: G
authors.lastname: Auzanneau
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D012074:Remission Induction; D015996:Survival Rate
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone; D011241:Prednisone