Phase II evaluation of a high-dose mitoxantrone based induction regimen in untreated adults with acute myeloid leukemia.
To evaluate a regimen including high-dose mitoxantrone in previously untreated adults with AML, 45 patients aged 21-59 (median 41) were given cytarabine, 3 g/m2 days 1-5, mitoxantrone, 80 mg/m2 day 2 and etoposide, 150 mg/m2 days 1,3,5. Post-remission therapy consisted of 5 cycles combining the same agents at reduced doses. Complete remission was seen in 36 patients. The observed 3-year survival is 28%. Cytogenetic pattern and CD34 expression correlated with response and survival. Significant toxicity included myelosuppression, mucositis, diarrhea and hyperbilirubinemia. Ventricular ejection fraction was generally reduced, with clinical cardiac dysfunction in only 2 patients. This high-dose mitoxantrone combination can be administered to young adults with AML with tolerable toxicity and results comparable to those of other dose-intensive regimens.
Feldman
E J
EJ
New York Medical College and Zalmen A. Arlin Cancer Institute, Valhalla, USA.
Seiter
K
K
Traganos
F
F
Darzynkiewicz
Z
Z
Goff
H
H
Pozzuoli
M
M
Baskind
P
P
Santos
S
S
Ahmed
T
T
D000206:Actuarial Analysis; D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D003231:Conjunctivitis / Q000139:chemically induced; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D006932:Hyperbilirubinemia / Q000139:chemically induced; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage* / Q000009:adverse effects; D012074:Remission Induction; D012306:Risk; D013280:Stomatitis / Q000139:chemically induced; D013318:Stroke Volume / Q000187:drug effects; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced
D003561:Cytarabine; D014212:Tretinoin; D005047:Etoposide; D008942:Mitoxantrone; D008775:Methylprednisolone