title: Dose escalation of ara-c may improve response rates in a subgroup of chronic myeloid leukemia patients with poor response to interferon-alpha and low-dose ara-C.
abstract: The present analysis was performed to evaluate the impact of cytosine arabinoside (ara-C) dose escalation on hematological and cytogenetic responses in patients with chronic myelogenous leukemia (CML) who failed to respond to low-dose ara-C (LD ara-C) at a dose of 10 mg/m2/d over 10 days per month and interferon-alpha (IFNalpha, 3.5 MU/d). Following the same administration schedule, dose escalation of ara-C to 15 and 20 mg/m2/d 1-10 was performed in 36 of 119 patients (30%) due to inadequate hematological response and/or disease progression. As a result, improvement of hematological and cytogenetic responses was achieved in 22 (61%) and nine (25%) patients, respectively. Escalated ara-C dose levels were usually well tolerated, although some patients experienced deterioration of preexisting side effects. Our results support the critical role of ara-C dose towards a better disease control in CML.
authors.affiliation: Department of Internal Medicine, University Hospital, Innsbruck, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Hilbe
authors.forename: T
authors.initials: T
authors.lastname: Kühr
authors.forename: U
authors.initials: U
authors.lastname: Apfelbeck
authors.forename: M
authors.initials: M
authors.lastname: Fridrik
authors.forename: H
authors.initials: H
authors.lastname: Seewann
authors.forename: M
authors.initials: M
authors.lastname: Stöger
authors.forename: W
authors.initials: W
authors.lastname: Linkesch
authors.forename: J
authors.initials: J
authors.lastname: Pont
authors.forename: C
authors.initials: C
authors.lastname: Baldinger
authors.forename: E
authors.initials: E
authors.lastname: Hartner
authors.forename: M
authors.initials: M
authors.lastname: Bernhart
authors.forename: D
authors.initials: D
authors.lastname: Geissler
authors.forename: O
authors.initials: O
authors.lastname: Krieger
authors.forename: A
authors.initials: A
authors.lastname: Lang
authors.forename: W
authors.initials: W
authors.lastname: Lin
authors.forename: H
authors.initials: H
authors.lastname: Ludwig
authors.forename: C
authors.initials: C
authors.lastname: Duba
authors.forename: R
authors.initials: R
authors.lastname: Greil
authors.forename: G
authors.initials: G
authors.lastname: Gast
authors.forename: J
authors.initials: J
authors.lastname: Thaler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D016898:Interferon-alpha; D003561:Cytarabine