Results of conventional-dose cytosine arabinoside and idarubicin in elderly patients with acute myeloid leukemia.
Conventional-dose Ara-C (200 mg/m2 d 1-5) combined with idarubicin (12 mg/m2 d 1-3) was employed as remission induction and consolidation therapy in 23 elderly AML patients with a median age of 66 years (range, 60-75) with AML according to the FAB criteria (M1 n = 3, M2 n = 10, M4 n = 6, M5 n = 2, M6 n = 2), eligible for the study. In seven patients earlier MDS had been documented by previous bone marrow aspirates. The CR rate after one induction course was 65% (15/23). Toxicity was acceptable, with four patients dying during the chemotherapy-induced hypoplasia (4/23). Although 80% of the CR patients received two additional cycles of Ara-C and idarubicin as consolidation therapy, only two patients are still in continuous complete remission more than 12 months after achieving CR. The median disease-free survival of the CR patients was 11.5 months and the median survival of the entire group was 10 months. We conclude that conventional dose Ara-C/idarubicin is an effective protocol for inducing complete remission in elderly patients with AML, but that consolidation therapy consisting of two courses of the same regimen does not produce a relevant rate of long-term disease-free survival.
Klinik für Hämatologie, Onkologie und klinische Immunologie, Universität Düsseldorf, Germany.
A
A
Heyll
C
C
Aul
F
F
Gogolin
V
V
Runde
D
D
Söhngen
G
G
Meckenstock
H H
HH
Wolf
J
J
Zahner
M
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Burk
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M
Winkelmann
D000208:Acute Disease; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage*; D004915:Leukemia, Erythroblastic, Acute / Q000188:drug therapy / Q000453:epidemiology; D007948:Leukemia, Monocytic, Acute / Q000188:drug therapy / Q000453:epidemiology; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000453:epidemiology; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000453:epidemiology; D015479:Leukemia, Myelomonocytic, Acute / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D016019:Survival Analysis
D003561:Cytarabine; D015255:Idarubicin