title: Clinical efficacy of mitoxantrone and Ara-C with or without etoposide salvage chemotherapy in adult patients with relapsed or refractory acute lymphoblastic leukemia: retrospective multicenter study of the Korean Adult ALL Working Party.
abstract: Mitoxantrone is a conventional agent for relapsed or refractory acute lymphoblastic leukemia (ALL). However, an effective combination with other drugs and a feasible dosage has not been identified. A retrospective study of 46 patients with relapsed or refractory ALL was conducted to determine the efficacy of mitoxantrone and Ara-C treatment with (MEC) and or without etoposide (MC). Twenty-seven and 19 patients received MC and MEC chemotherapy, respectively. Twenty-two (48%) patients showed overall response [complete response (CR), 33%; CR with incomplete platelet recovery (CRp), 15%], and 10 of 22 responders received allogeneic stem cell transplantation (SCT). Median overall survival (OS) was 6.2 months (95% confidence interval, 3.41-9.0). Thirteen (48%) patients in the MC group and 9 (47%) in the MEC group achieved CR/CRp (p = 0.96). Treatment-related mortalities in the MC and MEC groups were 3 (11%) and 4 (21%), respectively (p = 0.36). However, the MEC group frequently presented with grade 3 or higher bacteremia/candidemia (p = 0.013). No difference in OS was observed between the two groups (p = 0.769). In conclusion, salvage therapy consisting of mitoxantrone and Ara-C without etoposide appeared to be an effective bridge therapy to allogeneic SCT for patients with refractory or relapsed ALL.
authors.affiliation: Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University, Hwasun, Republic of Korea.
authors.forename: Jae-Sook
authors.initials: JS
authors.lastname: Ahn
authors.forename: Deok-Hwan
authors.initials: DH
authors.lastname: Yang
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Jung
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.forename: Inho
authors.initials: I
authors.lastname: Kim
authors.forename: Seonyang
authors.initials: S
authors.lastname: Park
authors.forename: Joo Seop
authors.initials: JS
authors.lastname: Chung
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Dae-Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Sohn
authors.forename: Ik-Chan
authors.initials: IC
authors.lastname: Song
authors.forename: Deog-Yeon
authors.initials: DY
authors.lastname: Jo
authors.forename: Young Don
authors.initials: YD
authors.lastname: Joo
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone