Treatment of blastic phase chronic myeloid leukemia with mitoxantrone, cytosine arabinoside and high dose methylprednisolone.
Fourteen patients with blastic phase chronic myelogenous leukemia received combination chemotherapy with mitoxantrone 5 mg/m2 intravenously daily for 3 days, cytosine arabinoside 100 mg/m2 intravenously over 2 hours bid for 7 days and high dose methylprednisolone 1000 mg/day intravenously for 5 days. The patients' mean age was 52 +/- 10 (range 34-64) and Philadelphia chromosome was positive in all. Five patients (35%) achieved complete remission and four patients (28%) had a partial remission. Overall remission rate was 64%. The mean survival was 11.1 +/- 8.6 months (median 13) for all patients, 19.4 +/- 4.0 months (median 19) for those achieving a complete remission, 12.50 +/- 5.7 months (median 14) for patients with partial remission and 1.8 +/- 1.8 months (median 2) for the unresponsive patients. Two of 5 unresponsive patients died early after the second course of remission induction. The treatment regimen was generally well tolerated. Marrow hypoplasia was observed in 9 (64%) patients and 7 (50%) had febrile episodes. Non-myelosupressive toxicity of the regimen was acceptable. Nausea and vomiting were observed in 8 (57%) patients and 3 (21%) patients developed flushing due to cytosine arabinoside. These results suggest that the regimen with mitoxantrone, cytosine arabinoside and high dose methylprednisolone in remission-induction of blastic phase chronic myelogenous leukemia may be a valid option that may also improve overall prognosis.
Bolaman
Zahit
Z
Adnan Menderes University Medical School, Department of Internal Medicine, Aydin, Turkey. zahitb@yahoo.com
Köseoğlu
Mehmet
M
Ayyildiz
Orhan
O
Kadiköylü
Gürhan
G
Sönmez
Hulki Meltem
HM
Demir
Süleyman
S
Müftüoğlu
Ekrem
E
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use* / Q000633:toxicity; D001752:Blast Crisis / Q000188:drug therapy*; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
D003561:Cytarabine; D008942:Mitoxantrone; D008775:Methylprednisolone