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Phase II study of low‐dose continuous infusion homoharringtonine in refractory acute myelogenous leukemia
Author(s) -
Kantarjian Hagop M.,
Keating Michael J.,
Walters Ronald S.,
Koller Charles A.,
McCredie Kenneth B.,
Freireich Emil J.
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890301)63:5<813::aid-cncr2820630502>3.0.co;2-v
Subject(s) - homoharringtonine , medicine , chronic myelogenous leukemia , leukemia , refractory (planetary science) , gastroenterology , anesthesia , surgery , physics , astrobiology
Thirty‐one patients with a diagnosis of refractory acute myelogenous leukemia received homoharringtonine as their first (15 patients) or second (16 patients) salvage therapy. Homoharringtonine was given as a continuous infusion of 2.5 mg/m 2 daily for 15 to 21 days to 13 patients (schedule 1), and of 3.0 mg/m 2 daily for 15 days in 18 patients (schedule 2). Overall, one patient achieved complete remission (3%), and three (10%) had a hematologic improvement with normalization of the marrow and peripheral blood picture except for persistent thrombocytopenia. Six patients (19%) demonstrated prolonged myelosuppression, three (23%) on schedule 1 and three (17%) on schedule 2. Cardiovascular complications were minimal consisting of hypotension in one patient (3%) and supraventricular arrthymias in two patients (6%). Hyperglycemia was observed in 42% of patients and was significant in 10%. The authors conclude that homoharringtonine, at the dose schedule investigated, has definite but low antileukemic efficacy. The low‐dose continuous infusion schedule was associated with prolonged myelosuppression but no serious cardiovascular complications. The role of such therapy in myeloproliferative disorders, especially chronic myelogenous leukemia, deserves consideration.