title: Dose-reduced combination of mitoxantrone, etoposide, and cytarabine (miniMEC) for relapsed and refractory acute leukemia.
abstract: The combination of mitoxantrone (MIT), etoposide (ETP), and cytarabine (Ara-C) (MEC) is a frequently used salvage therapy for acute leukemia, but has been associated with severe myelosuppression. Therefore, we investigated the miniMEC regimen with reduced doses of AraC and MIT. Thirteen ALL and 44 AML patients, all relapsed or refractory, received miniMEC, which consisted of MIT at 8 mg/m(2) for 3 d, ETP at 100 mg/m(2) for 5 d, and Ara-C at 100 mg/m(2) infused over 24 h for 7 d. CR + CRi was achieved in eight ALL patients (61.5%) and 16 AML patients (36.4%). Median duration of neutropenia was 30 d (range, 1-50). Thirty-one patients (54.4%) subsequently received allogeneic stem cell transplantation (SCT), and overall survival was significantly improved in this group (median OS 161 versus 481 d, p = 0.006). We concluded that miniMEC is a safe and effective bridging therapy to SCT.
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Chihiro
authors.initials: C
authors.lastname: Yamamoto
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Shoko
authors.initials: S
authors.lastname: Ito
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Mashima
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Kento
authors.initials: K
authors.lastname: Umino
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Daisuke
authors.initials: D
authors.lastname: Minakata
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Ryoko
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nakano
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ashizawa
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Okazuka
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hatano
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Iekuni
authors.initials: I
authors.lastname: Oh
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Fujiwara
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Ken
authors.initials: K
authors.lastname: Ohmine
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;|b Division of Cell Transplantation and Transfusion , Jichi Medical University , Tochigi , Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.affiliation: a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008942:Mitoxantrone
keywords: Chemotherapeutic approaches; lymphoid leukemia; myeloid leukemias and dysplasias