title: A randomized phase II study on the effects of 5-Aza-2'-deoxycytidine combined with either amsacrine or idarubicin in patients with relapsed acute leukemia: an EORTC Leukemia Cooperative Group phase II study (06893).
abstract: 5-Aza-2'-deoxycytidine combined with either amsacrine or idarubicin has been applied in a treatment protocol for patients with a relapse of acute myeloid or lymphocytic leukemia. Sixty-three patients received 5-Aza-2'-deoxycytidine 125 mg/m2 as a 6 h infusion every 12 h for 6 days in combination with either amsacrine 120 mg/m2 as a 1 h infusion on days 6 and 7 (n=30) or idarubicin 12 mg/m2 as a 15 min infusion on days 5, 6 and 7 (n = 33). Twenty-three patients (36.5%) obtained a complete remission (CR); eight of 30 patients treated with amsacrine and 15 of 33 treated with idarubicin. Patients with an interval of more than 1 year between initial diagnosis and start of the protocol achieved CR in 51.4%, compared to 15.4% for patients with an interval of less than 1 year. Patients with normal cytogenetics had a higher CR rate (61%) than those with abnormal cytogenetic findings (15.8%). Digestive tract and hematologic toxicity was prolonged, compared to standard induction schedules. Median disease-free survival was approximately 8 months, with only 20% of patients staying in remission for more than 1 year. 5-Aza-2'-deoxycytidine is a good antileukemic agent with considerable toxicity. Current results merit further investigations in previously untreated leukemia.
authors.affiliation: Academisch Ziekenhuis Leiden, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Willemze
authors.forename: S
authors.initials: S
authors.lastname: Suciu
authors.forename: E
authors.initials: E
authors.lastname: Archimbaud
authors.forename: P
authors.initials: P
authors.lastname: Muus
authors.forename: P
authors.initials: P
authors.lastname: Stryckmans
authors.forename: E A
authors.initials: EA
authors.lastname: Louwagie
authors.forename: Z
authors.initials: Z
authors.lastname: Berneman
authors.forename: M
authors.initials: M
authors.lastname: Tjean
authors.forename: P
authors.initials: P
authors.lastname: Wijermans
authors.forename: H
authors.initials: H
authors.lastname: Dohner
authors.forename: U
authors.initials: U
authors.lastname: Jehn
authors.forename: B
authors.initials: B
authors.lastname: Labar
authors.forename: B
authors.initials: B
authors.lastname: Jaksic
authors.forename: M
authors.initials: M
authors.lastname: Dardenne
authors.forename: R
authors.initials: R
authors.lastname: Zittoun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001374:Azacitidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000077209:Decitabine; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D012008:Recurrence; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D000677:Amsacrine; D000077209:Decitabine; D001374:Azacitidine; D015255:Idarubicin