Treatment of the blast crisis of chronic myelogenous leukemia with 5-azacitidine and VP-16-213.
Twenty-seven patients with chronic myelogenous leukemia in blast crisis were treated with a combination of 5-azacitidine (150 mg/m2/day iv in 3 divided doses x 5 days) and VP-16-213 (75 mg/m2/day x 5). No patient had lymphoid histology, and terminal transferase was not present in the 12 patients tested. One complete and 15 partial responses (58% response rate) were seen, with a median survival of 231 days for responders and 73 days for patients who failed to achieve a partial response (P = 0.008). The overall survival was 161 days (range, 20-316+). Moderately severe nausea and vomiting, muscle aches, and mucositis (two patients) were the major side effects, although toxic effects tended to decrease with subsequent courses and many patients could be treated on an outpatient basis. These results compare favorably with other results in this refractory disorders and suggest that 5-azacitidine and VP-16-213 be studied further, either in higher doses or in combination with other agents, in therapy for chronic myelogenous leukemia in blast crisis.
D000328:Adult; D000368:Aged; D001374:Azacitidine / Q000008:administration & dosage* / Q000009:adverse effects; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005047:Etoposide / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011034:Podophyllotoxin / Q000031:analogs & derivatives*
D005047:Etoposide; D011034:Podophyllotoxin; D001374:Azacitidine