Combined low-dose cytarabine, melphalan and mitoxantrone for older patients with acute myeloid leukemia or high-risk myelodysplastic syndrome.
BACKGROUND
Low-dose cytarabine (ara-C) has been used to treat older patients with acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS), but has resulted in complete remission for <20% of cases. A pilot study of the efficacy of a combination chemotherapy using low-dose ara-C, melphalan (Mel), and mitoxantrone (Mit) was conducted.


METHODS
The treatment comprised ara-C (10 mg/m2) twice daily, melphalan (2 mg/body) every other day, and mitoxantrone (3 mg/m2) every 3 days. The treatment was discontinued if the nuclear cell count was <15,000/microl with <20% blast count in the bone marrow. The primary end-points were initial response and tolerability.


RESULTS
The study comprised 9 patients with AML or high-risk MDS (median age, 75 years). Complete remission was achieved in 3 patients. All the patients displayed grade 4 neutropenia and thrombocytopenia. One patient died from sepsis.


CONCLUSIONS
The present regimen was more effective and displayed similar safety, compared with low-dose ara-C alone.
Yamauchi
Takahiro
T
Department of Hematology and Oncology, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan. tyamauch@fmsrsa.fukui-med.ac.jp
Negoro
Eiju
E
Arai
Hajime
H
Ikegaya
Satoshi
S
Takagi
Kazutaka
K
Takemura
Haruyuki
H
Inai
Kunihiro
K
Yoshida
Akira
A
Urasaki
Yoshimasa
Y
Iwasaki
Hiromichi
H
Ueda
Takanori
T
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000754:Anemia, Refractory, with Excess of Blasts / Q000188:drug therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D010865:Pilot Projects
D003561:Cytarabine; D008942:Mitoxantrone; D008558:Melphalan