High-dose cytarabine and mitoxantrone in consolidation therapy for acute promyelocytic leukemia.
The objective of our study was to evaluate high-dose cytarabine in consolidation therapy in patients with newly diagnosed acute promyelocytic leukemia (APL). Patients (age 16-60 years) received induction therapy according to the AIDA protocol (all-trans retinoic acid, idarubicin) followed by one cycle of ICE (idarubicin, cytarabine, etoposide) and two cycles of HAM (cytarabine 3 g/m(2) q12h, days 1-3; mitoxantrone 10 mg/m(2), days 2 and 3). From 1995 to 2003, 82 patients were enrolled. In total, 72 patients (88%) achieved a complete remission, and 10 patients (12%) died from early/hypoplastic death (ED/HD). A total of 71 patients received at least one cycle of HAM. Relapse-free survival (RFS) and overall survival (OS) after 46 months were 83 and 82%, respectively. White blood cell count above 10.0 x 10(9)/l at diagnosis and additional chromosomal aberrations were unfavorable prognostic markers for OS, whereas no prognostic markers for RFS were identified including FLT3 mutations. In conclusion, high-dose cytarabine in consolidation therapy for patients with newly diagnosed APL is an effective treatment approach.
Schlenk
R F
RF
Department of Internal Medicine III, University Hospital of Ulm, 89081 Ulm, Germany. richard.schlenk@medizin.uni-ulm.de
Germing
U
U
Hartmann
F
F
Glasmacher
A
A
Fischer
J T
JT
del Valle y Fuentes
F
F
Götze
K
K
Pralle
H
H
Nerl
C
C
Salwender
H
H
Grimminger
W
W
Petzer
A
A
Hensel
M
M
Benner
A
A
Zick
L
L
Döhner
K
K
Fröhling
S
S
Döhner
H
H
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003561:Cytarabine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage*; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000235:genetics; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics; D012074:Remission Induction; D014212:Tretinoin / Q000008:administration & dosage*; D051941:fms-Like Tyrosine Kinase 3
D011518:Proto-Oncogene Proteins; D003561:Cytarabine; D014212:Tretinoin; D008942:Mitoxantrone; C497970:FLT3 protein, human; D020794:Receptor Protein-Tyrosine Kinases; D051941:fms-Like Tyrosine Kinase 3; D015255:Idarubicin