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Mitoxantrone and high‐dose cytosine arabinoside for the treatment of refractory acute lymphocytic leukemia
Author(s) -
Kantarjian Hagop M.,
Walters Ronald L.,
Keating Michael J.,
Estey Elihu H.,
O'Brien SUSAN,
Schachner Jay,
McCredie Kenneth B.,
Freireich Emil J
Publication year - 1990
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(19900101)65:1<5::aid-cncr2820650104>3.0.co;2-r
Subject(s) - mitoxantrone , medicine , refractory (planetary science) , cytarabine , chemotherapy , leukemia , acute lymphocytic leukemia , gastroenterology , regimen , salvage therapy , cytosine , acute leukemia , surgery , lymphoblastic leukemia , dna , physics , astrobiology , biology , genetics
Twenty‐five adult patients with refractory acute lymphocytic leukemia received salvage therapy with mitoxantrone 5 mg/m 2 intravenously over 1 hour daily for 5 days and cytosine arabinoside 3 g/m 2 intravenously over 2 hours every 12 hours for six doses. Overall, nine patients (36%) achieved complete remission, eight (32%) died during induction, and eight (32%) had resistant disease. No significant associations were found between pretreatment patient characteristics and remission. Remission durations were short with a median of 9 weeks; the overall median survival was 10 weeks. The major dose‐limiting toxic effects were related to myelosuppression. Febrile episodes requiring hospitalization occurred in 23 patients (92%), including five episodes of fever of unknown origin (20%) and 18 episodes of documented infections (72%). The authors conclude that the combination of mitoxantrone and high‐dose cytosine arabinoside has significant activity in adults with refractory acute lymphocytic leukemia. The addition of colony‐stimulating growth factors to the intensive chemotherapy, and the use of the combination regimen as part of front‐line maintenance intensification therapy may further improve the prognosis in these patients.