title: Phase II trial of amsacrine plus intermediate-dose Ara-C (IDAC) with or without etoposide as salvage therapy for refractory or relapsed acute leukemia.
abstract: OBJECTIVE
  The current trial attempted to evaluate the efficacy and toxicity of a salvage therapy consisting of amsacrine plus intermediate-dose Ara-C (IDAC) with or without etoposide for acute leukemia patients in refractory or relapsed states.
  
  
  METHODS
  A total of 51 patients with refractory or relapsed acute leukemia were included in the current trial. Twenty-nine patients with acute myeloid leukemia (AML) received a salvage therapy of amsacrine plus IDAC and etoposide, while 22 patients with acute lymphoblastic leukemia (ALL) received amsacrine plus IDAC.
  
  
  RESULTS
  The overall complete remission rate was 55% (45% for AML, 68% for ALL) and the median duration of overall survival was 144 days (95% confidence interval = 101-186 days). Grade 3, 4 infectious toxicities were observed in 43 patients (87%), while treatment-related toxicity, excluding infectious causes, included heart failure from myocarditis (n = 1) and central nervous system toxicity (n = 1).
  
  
  CONCLUSIONS
  A salvage therapy consisting of amsacrine plus IDAC with or without etoposide appears to be safe and an effective bridge therapy into a stem cell transplantation programme for patients with refractory or relapsed acute leukemia.
authors.affiliation: Department of Hematology/Oncology, Kyungpook National University Hospital, Jung-gu, Daegu 700-721, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Sung
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Kim
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Jong Gwang
authors.initials: JG
authors.lastname: Kim
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Baek
authors.forename: Seok Bong
authors.initials: SB
authors.lastname: Jeon
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Byung Min
authors.initials: BM
authors.lastname: Ahn
authors.forename: Kyu Bo
authors.initials: KB
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000677:Amsacrine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D003967:Diarrhea / Q000139:chemically induced; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D012074:Remission Induction; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome; D014840:Vomiting, Anticipatory / Q000209:etiology
chemical_list: D000677:Amsacrine; D003561:Cytarabine; D005047:Etoposide