Combination chemotherapy utilizing continuous infusion of intermediate-dose cytarabine for refractory or recurrent acute myeloid leukemia.
Between October 1991 and December 1998, 19 patients (12 males and 7 females) with refractory (six patients) or recurrent (13 patients) AML were treated with a combination chemotherapy of cytarabine given by continuous infusion over 24-h at a rate of 1 upward arrow g/m2 per day for 5 days along with idarubicin (12 upward arrow mg/m2 per day x 3) and etoposide (150 mg /m(2) per day x 3). Median age of the patients was 28 years (range, 15--61). Seven (37%) of 19 patients achieved complete remission (CR) with median CR duration of 6.7 months (range, 2.5--61.4+). Two patients are surviving for long term (50.1 and 62.6 months). Myelosuppression associated with chemotherapy was severe. Median recovery time to ANC over 500/microl was 28 days (range, 25--59). A significant proportion of patients experienced grade III-VI non-hematologic toxicities including nausea/vomiting (32%), liver function abnormality (32%), and diarrhea (16%). No central nervous system (CNS) toxicity was observed. Our study showed that the administration of cytarabine at a dose of 1 g/m(2) per day by continuous intravenous infusion for 5 days along with idarubicin and etoposide was feasible. Further studies are necessary to elucidate optimum dose and schedule of cytarabine in a setting of refractory or relapsed acute myeloid leukemia (AML).
Bahng
H
H
Section of Oncology-Hematology, Department of Medicine, University of Ulsan, Asan Medical Center, 388-1 Poongnap-dong, Songpa-ku, Seoul, Republic of South Korea 138-736.
Lee
J H
JH
Ahn
J H
JH
Lee
J H
JH
Lee
J S
JS
Kim
S H
SH
Kim
W K
WK
Lee
K H
KH
D000206:Actuarial Analysis; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000633:toxicity; D003561:Cytarabine / Q000008:administration & dosage* / Q000633:toxicity; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007951:Leukemia, Myeloid / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
D003561:Cytarabine