title: Durable second complete remissions with oral melphalan in hypocellular Acute Myeloid Leukemia and Refractory Anemia with Excess Blast with normal karyotype relapsing after intensive chemotherapy.
abstract: We treated six patients who had relapsed after intensive chemotherapy, presenting initially with AML or RAEB, a hypocellular marrow and normal karyotype, and who were deemed unsuitable for re-induction with intensive chemotherapy, with low dose oral melphalan. Three of six patients achieved complete hematological response with no significant toxicity and with a duration of 12, 8 and 3+ months respectively. These three patients had received only two prior courses of chemotherapy each, in contrast to non-responders who were more heavily pre-treated. Low dose melphalan is highly effective therapy for this rare subtype of AML/RAEB, even in relapsed disease with limited prior chemotherapy.
authors.affiliation: Department of Hematology, St. James's Institute of Oncology, Leeds, United Kingdom.
authors.forename: Annika M
authors.initials: AM
authors.lastname: Whittle
authors.affiliation: Department of Haematology, Huddersfield and Calderdale NHS Trust, Huddersfield, United Kingdom.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Feyler
authors.affiliation: Department of Hematology, St. James's Institute of Oncology, Leeds, United Kingdom.
authors.forename: David T
authors.initials: DT
authors.lastname: Bowen
keywords: Acute Myeloid Leukemia; Melphalan; Myelodysplastic syndromes; Refractory Anemia with Excess Blasts