Phase II study of low-dose continuous infusion homoharringtonine in refractory acute myelogenous leukemia.
Thirty-one patients with a diagnosis of refractory acute myelogenous leukemia received homoharringtonine as their first (15 patients) or second (16 patients) salvage therapy. Homoharringtonine was given as a continuous infusion of 2.5 mg/m2 daily for 15 to 21 days to 13 patients (schedule 1), and of 3.0 mg/m2 daily for 15 days in 18 patients (schedule 2). Overall, one patient achieved complete remission (3%), and three (10%) had a hematologic improvement with normalization of the marrow and peripheral blood picture except for persistent thrombocytopenia. Six patients (19%) demonstrated prolonged myelosuppression, three (23%) on schedule 1 and three (17%) on schedule 2. Cardiovascular complications were minimal consisting of hypotension in one patient (3%) and supraventricular arrhythmias in two patients (6%). Hyperglycemia was observed in 42% of patients and was significant in 10%. The authors conclude that homoharringtonine, at the dose schedule investigated, has definite but low antileukemic efficacy. The low-dose continuous infusion schedule was associated with prolonged myelosuppression but no serious cardiovascular complications. The role of such therapy in myeloproliferative disorders, especially chronic myelogenous leukemia, deserves consideration.
Kantarjian
H M
HM
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Keating
M J
MJ
Walters
R S
RS
Koller
C A
CA
McCredie
K B
KB
Freireich
E J
EJ
D000328:Adult; D000368:Aged; D000470:Alkaloids / Q000008:administration & dosage*; D001853:Bone Marrow / Q000187:drug effects; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D006248:Harringtonines / Q000008:administration & dosage* / Q000009:adverse effects; D000077863:Homoharringtonine; D006801:Humans; D007262:Infusions, Intravenous; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction
D000470:Alkaloids; D006248:Harringtonines; D000077863:Homoharringtonine