Efficacy of etoposide and mitoxantrone in patients with acute myelogenous leukemia refractory to standard induction therapy and intermediate-dose cytarabine with amsidine

S. Daenen, B. Lowenberg, P Sonneveld, W.L.J. van Putten, G. Verhoef, M van Veldhoven, P.C. Huijgens

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    Abstract

    Thirty-seven newly diagnosed patients with acute myeloid leukemia (AML) who were not in complete remission (CR) after induction chemotherapy with cytarabine and daunorubicin followed by intermediate-dose cytarabine and amsacrine, were treated with mitoxantrone and etoposide in a prospective, open multicenter study. The aim was to examine the efficacy and the toxicity of mitoxantrone and etoposide in a patient population with bad prognosis because of refractoriness to two standardized induction courses. Twelve patients attained CR (32.4%). Responders were found only among the patients with documented susceptibility (i.e. partial remission) to the previous therapy. In responding patients the median remission duration and disease-free survival was 15+ months (range 3-52+). Toxicity was mainly hematologic and characterized by prolonged hypoplasia; one patient died in aplasia. Granulocytes and platelets recovered unexpectedly early in six of 22 non-responders. This study suggests that AML patients refractory to two standardized chemotherapy courses can still attain a durable CR after an additional course, here with mitoxantrone and etoposide, provided they show some responsiveness to the previously given cytostatic drugs.

    Original languageEnglish
    Pages (from-to)6-10
    Number of pages5
    JournalLeukemia
    Volume8
    Issue number1
    Publication statusPublished - Jan-1994

    Keywords

    • ACUTE MYELOID-LEUKEMIA
    • ACUTE NONLYMPHOCYTIC LEUKEMIA
    • TOPOISOMERASE-II ACTIVITY
    • CYTOSINE-ARABINOSIDE
    • GENE-EXPRESSION
    • AMSACRINE
    • RESISTANT
    • REGIMEN
    • COMBINATION
    • ADULT

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