Topotecan (hycamptin) and topotecan-containing regimens in the treatment of hematologic malignancies.
Single-agent topotecan is an active drug in chemotherapy-naive MDS and CMML and, to a lesser degree, in refractory/relapsed acute leukemias, low-/intermediate-grade lymphoma, and myeloma. Its combination with cytosine arabinoside induces complete remissions in high-risk MDS/CMML. A triple-combination regimen of cyclophosphamide, cytosine arabinoside, and topotecan (CAT) was extensively tested in refractory/relapsed as well as in untreated AML. By proving effective in inducing complete remission in newly diagnosed AML at rates comparable to those achieved by anthracycline-cytosine arabinoside regimens, for example, CAT offers a useful treatment alternative. Topotecan combined with paclitaxel is promising in low-/intermediate-grade lymphomas. The activity of topotecan justifies further evaluation of topotecan-containing combination regimens, particularly in MDS/CMML and acute leukemias.
Beran
M
M
Department of Leukemia, Division of Medicine, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard/Box 61, Houston, Texas 77030-4095, USA. mberan@mdanderson.org
Kantarjian
H M
HM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D006801:Humans; D019772:Topotecan / Q000008:administration & dosage / Q000627:therapeutic use*
D004791:Enzyme Inhibitors; D003561:Cytarabine; D019772:Topotecan; D003520:Cyclophosphamide