Chapter title |
Mitoxantrone, cytosine arabinoside, and VP-16 in 36 patients with relapsed and refractory acute myeloid leukemia.
|
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Chapter number | 60 |
Book title |
Acute Leukemias II
|
Published in |
Haematology and blood transfusion, January 1990
|
DOI | 10.1007/978-3-642-74643-7_60 |
Pubmed ID | |
Book ISBNs |
978-3-54-050984-4, 978-3-64-274643-7
|
Authors |
Link, H, Freund, M, Diedrich, H, Wilke, H, Austein, J, Henke, M, Wandt, H, Fackler-Schwalbe, E, Schlimok, G, Hoffmann, R, Link, H., Freund, M., Diedrich, H., Wilke, H., Austein, J., Henke, M., Wandt, H., Fackler-Schwalbe, E., Schlimok, G., Hoffmann, R., Calavrezos, A., Poliwoda, H. |
Abstract |
Mitoxantrone in combination with VP-16 proved to be effective in refractory and relapsed acute myeloid leukemia (AML), with 42% of patients achieving complete remission (CR). The aim of this study was to assess whether the addition of cytosine arabinoside increased the response rate at a tolerable toxicity. The regimen consisted of mitoxantrone (M) 10 mg/m2 i.v. days 4-8, cytosine arabinoside (A) 100 mg/m2 continuous infusion days 1-8, and etoposide (VP-16) (V) 100-120 mg/m2 i.v. days 4-8 (MAV protocol) for relapsed and refractory AML. Thirty-six patients were treated, with a median age of 51 (20-73) years. For induction therapy one to two MAV cycles and for consolidation therapy two courses were scheduled. Twenty-one (58.3%) patients attained a complete remission (CR), with a median duration of 4.5 (1-12+) months. The median survival of all patients was 5.5 (0.5-15.5+) months. Four patients died in CR from chronic infections or after consolidation therapy with MAV. In evaluable patients, times to greater than 500 granulocytes/microliters and greater than 25,000 platelets/microliters were 23 (7-46) and 23 (6-44) days, respectively. In 54 evaluable MAV courses the following toxicity was observed (WHO grades 3/4): 26%, nausea and vomiting: 9%, hemorrhage; 6%, bilirubinemia; 11%, diarrhea; 22%, mucositis; 6%, local infection; 20%, septicemia; 13%, fever of unknown origin; 2%, cardiac arrhythmia; 7%, congestive heart failure. We conclude that MAV therapy is a highly active antileukemic combination with acceptable toxicity, which is recommended for further clinical trials in untreated AML. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 1 | 5% |
Unknown | 18 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 3 | 16% |
Student > Bachelor | 3 | 16% |
Other | 2 | 11% |
Student > Ph. D. Student | 2 | 11% |
Student > Master | 2 | 11% |
Other | 4 | 21% |
Unknown | 3 | 16% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 63% |
Social Sciences | 1 | 5% |
Sports and Recreations | 1 | 5% |
Unknown | 5 | 26% |