title: Intermediate-dose cytosine arabinoside and amsacrine. An effective regimen with low toxicity in refractory acute nonlymphocytic leukemia.
abstract: Results of remission induction therapy in refractory acute nonlymphocytic leukemia (ANLL) has been improved since the introduction of high-dose cytosine arabinoside. However, the toxicity of these regimens attributes to an early death rate of about 20% to 30%. The authors treated 37 poor-risk patients with ANLL with intermediate-dose cytosine arabinoside and amsacrine for remission induction. One consolidation course and no maintenance therapy was given. Eleven of 19 patients with a first relapse entered complete remission (58%); ten of 15 patients in this group older than 50 years were complete responders (67%). Median duration of second remission was 8.2 months (range, 2-14). Three of 13 patients with primarily resistant disease had a complete remission (23%), but there was no response in five patients with a myeloid blastic phase of chronic myelogenous leukemia. Side effects of this remission induction regimen were mild; no cardiac, pulmonary, or central nervous system toxicity was observed. Five patients (14%) died during the remission induction phase, three from complications during aplasia and two from refractory leukemia.
authors.affiliation: Department of Hematology, University Hospital Utrecht, The Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Dekker
authors.forename: H K
authors.initials: HK
authors.lastname: Nieuwenhuis
authors.forename: L F
authors.initials: LF
authors.lastname: Verdonck
mesh_terms: D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction
chemical_list: D000677:Amsacrine; D003561:Cytarabine