title: Mitoxantrone, etoposide, carboplatinum and ara-C combination therapy (MECA) in refractory and relapsed acute leukemia.
abstract: The present study was undertaken to assess the feasibility, toxicity and antileukemic activity of sequential chemotherapy including mitoxantrone, etoposide, carboplatin and intermediate-dose cytarabine in adult patients with refractory and relapsed acute myelogenous (AML) or lymphoid (ALL) leukemia. Fifty-one patients with poor-risk AML and ALL received 64 courses of MECA therapy. The overall response in the entire group was 51% (43% complete remission). The stage of the disease (relapsed or primarily refractory) and the age of the patients did not strongly affect the response rate. MECA therapy was more effective in ALL than in AML, and in those patients who presented at salvage treatment with a bone marrow infiltration lower than 25% blasts. Hematological and extra-hematological toxicities were tolerable and there were 6 deaths related to the treatment (11%). The incidence of documented infectious episodes was 71%. MECA therapy is a safe treatment and has a high antileukemic activity in relapsed and primarily refractory AML or ALL.
authors.affiliation: Department of Clinical Hematology, Hospital Duran i Reynals. Institut Català d'Oncologia, Barcelona, Spain. c.ferra@ico.scs.es
authors.forename: C
authors.initials: C
authors.lastname: Ferrá
authors.forename: J J
authors.initials: JJ
authors.lastname: Berlanga
authors.forename: D
authors.initials: D
authors.lastname: Gallardo
authors.forename: I
authors.initials: I
authors.lastname: Ancín
authors.forename: D
authors.initials: D
authors.lastname: Marín
authors.forename: J R
authors.initials: JR
authors.lastname: González
authors.forename: J
authors.initials: J
authors.lastname: Peris
authors.forename: J
authors.initials: J
authors.lastname: Muñoz
authors.forename: J
authors.initials: J
authors.lastname: Sarrá
authors.forename: A
authors.initials: A
authors.lastname: Grañena
mesh_terms: D000206:Actuarial Analysis; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D016190:Carboplatin / Q000008:administration & dosage / Q000633:toxicity; D003561:Cytarabine / Q000008:administration & dosage / Q000633:toxicity; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000633:toxicity; D012008:Recurrence; D012307:Risk Factors; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D005047:Etoposide; D016190:Carboplatin; D008942:Mitoxantrone