title: Salvage therapy with mitoxantrone, etoposide and cytarabine in relapsed or refractory acute lymphoblastic leukemia.
abstract: The survival of patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is poor. We performed a retrospective analysis of 40 patients treated with five days of mitoxantrone 8mg/m(2)/day, etoposide 100mg/m(2)/day, and cytarabine 1000mg/m(2)/day (MEC). The complete remission rate was 30% and median remission duration was 11.2 months. Median overall survival was 6.5 months. In univariate analysis, patients in first relapse had improved overall survival compared to ≥second relapse (p=0.02). Thirty-day mortality rate was 7.5%. In relapsed or refractory ALL, MEC demonstrated moderate activity, but did not improve survival compared to published salvage chemotherapy regimens.
authors.affiliation: Stanford University School of Medicine, Stanford, USA. Electronic address: mliedtke@stanford.edu.
authors.forename: Michaela
authors.initials: M
authors.lastname: Liedtke
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Tamara
authors.initials: T
authors.lastname: Dunn
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Shira
authors.initials: S
authors.lastname: Dinner
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Coutré
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Berube
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Gotlib
authors.affiliation: Department of Pharmacology, Stanford University School of Medicine, Stanford, CA 94305, USA.
authors.forename: Samit
authors.initials: S
authors.lastname: Patel
authors.affiliation: Stanford University School of Medicine, Stanford, USA.
authors.forename: Bruno
authors.initials: B
authors.lastname: Medeiros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000453:epidemiology*; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D016879:Salvage Therapy
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone
keywords: ALL; MEC; Salvage treatment