Treatment of relapsing and refractory adult acute myeloid leukemia according to in vitro clonogenic leukemic cell drug sensitivity.
In an attempt to improve the results of treatment in patients with relapsing or refractory acute myeloid leukemia (AML), we conducted a pilot study using a two-drug salvage regimen according to the in vitro clonogenic leukemic cell (CFU-L) drug sensitivity. Fourteen patients were included in the study, 10 with relapsing and 4 with refractory AML. Drug exposure was assessed for daunorubicin, cytosine arabinoside, etoposide, mitoxantrone and amsacrine. The two drugs with the best inhibitory effect on CFU-L were selected for the treatment. A complete remission was achieved in only 4 patients and a partial remission in 3 patients. Although the number of patients is too small for appropriate statistical analysis and for a definite conclusion to be drawn, the observed response rate with directed therapy did not appear better than that expected from empiric salvage regimen.
Service d'Hématologie, Hôtel-Dieu, Paris, France.
A
A
Delmer
J P
JP
Marie
D
D
Thevenin
A M
AM
Suberville
R
R
Zittoun
D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000494:pharmacology; D003630:Daunorubicin / Q000008:administration & dosage / Q000494:pharmacology; D005047:Etoposide / Q000008:administration & dosage / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000494:pharmacology; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D016879:Salvage Therapy; D014410:Tumor Stem Cell Assay
D000677:Amsacrine; D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone; D003630:Daunorubicin