High-dose cytosine arabinoside, daunomycin and 6-thioguanine in relapsed or refractory acute nonlymphocytic leukemia.
Fifteen patients with relapsed (10) or primarily refractory (5) acute nonlymphocytic leukemia were treated with a combination of cytosine arabinoside (3 g/m2 i.v. every 12 h, 12 doses, days 1-6), 6-thioguanine (100 mg/m2 orally every 12 h, 12 doses, days 1-6) and daunomycin (60 mg/m2 i.v. on days 5 and 6 only). Complete remission was achieved in 11 patients. Eight of 10 relapsed patients and 3 of 5 primarily refractory patients entered remission. Median remission duration was 7.5 months (2-36+ months). Ten of the 11 remissions resulted from a single induction course. The time to hematologic recovery was comparable to that seen with 'standard'-dose cytosine arabinoside regimens. Nonhematologic toxicity, although considerable, was not greater than that seen with high-dose cytosine arabinoside alone. The most significant problem was gastrointestinal toxicity with diarrhea occurring in the majority of patients. Mild neurologic toxicity (reversible cerebellar dysfunction) occurred in 2 patients.
Garewal
H
H
Section of Hematology-Oncology, Veterans Administration Medical Center, Tucson, Ariz.
Durie
B G
BG
Greenberg
B
B
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002526:Cerebellar Diseases / Q000139:chemically induced; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007938:Leukemia / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction; D013866:Thioguanine / Q000008:administration & dosage / Q000009:adverse effects
D003561:Cytarabine; D013866:Thioguanine; D003630:Daunorubicin