TY - JOUR
T1 - High dose cytarabine and mitoxantrone
T2 - An effective induction regimen for high-risk Acute Myeloid Leukemia (AML)
AU - Larson, Sarah M.
AU - Campbell, Nicholas P.
AU - Huo, Dezheng
AU - Artz, Andrew
AU - Zhang, Yanming
AU - Gajria, Devika
AU - Green, Margaret
AU - Weiner, Howie
AU - Daugherty, Christopher
AU - Odenike, Olatoyosi
AU - Godley, Lucy A.
AU - Hyjek, Elizabeth
AU - Gurbuxani, Sandeep
AU - Thirman, Michael
AU - Sipkins, Dorothy
AU - Van Besien, Koen
AU - Larson, Richard A.
AU - Stock, Wendy
PY - 2012/3
Y1 - 2012/3
N2 - Patients with high-risk AML, defined as those with advanced age, relapsed/refractory disease, unfavorable molecular and cytogenetic abnormalities, therapy-related myeloid neoplasm (t-MN) and multiple medical co-morbidities tend to respond poorly to standard cytarabine and daunorubicin induction therapy and have a poor prognosis. We performed a retrospective analysis of an alternative induction regimen using high dose cytarabine (HiDAC) and mitoxantrone (MITO) administered to 78 high-risk patients with AML at The University of Chicago from 2001 to 2008. The primary endpoints of the study were complete remission (CR) rate and death within 30 days of initiation of treatment. The median age was 63 years (range:2385); 27% of these patients had a Charlson co-morbidity index (CCI) > 2. Forty-three (56%) patients had unfavorable cytogenetics, 28 (37%) had intermediate-risk cytogenetics and 5 (7%) had favorable cytogenetics. The CR rate was 45% and the CRi rate 10%; 7 patients (9%) died during induction. Notably, t-MN and relapsed/refractory patients had CR and induction death rates equivalent to de novo AML patients within this series. In this high risk AML population, HiDAC/MITO induction demonstrated an overall response rate of 55% with a low induction death rate of 9% and allowed 32 (41%) patients to proceed to allogeneic stem cell transplant.
AB - Patients with high-risk AML, defined as those with advanced age, relapsed/refractory disease, unfavorable molecular and cytogenetic abnormalities, therapy-related myeloid neoplasm (t-MN) and multiple medical co-morbidities tend to respond poorly to standard cytarabine and daunorubicin induction therapy and have a poor prognosis. We performed a retrospective analysis of an alternative induction regimen using high dose cytarabine (HiDAC) and mitoxantrone (MITO) administered to 78 high-risk patients with AML at The University of Chicago from 2001 to 2008. The primary endpoints of the study were complete remission (CR) rate and death within 30 days of initiation of treatment. The median age was 63 years (range:2385); 27% of these patients had a Charlson co-morbidity index (CCI) > 2. Forty-three (56%) patients had unfavorable cytogenetics, 28 (37%) had intermediate-risk cytogenetics and 5 (7%) had favorable cytogenetics. The CR rate was 45% and the CRi rate 10%; 7 patients (9%) died during induction. Notably, t-MN and relapsed/refractory patients had CR and induction death rates equivalent to de novo AML patients within this series. In this high risk AML population, HiDAC/MITO induction demonstrated an overall response rate of 55% with a low induction death rate of 9% and allowed 32 (41%) patients to proceed to allogeneic stem cell transplant.
KW - Chemotherapeutic approaches
KW - Cytogenetics
KW - Myeloid leukemias and dysplasias
UR - http://www.scopus.com/inward/record.url?scp=84863137986&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863137986&partnerID=8YFLogxK
U2 - 10.3109/10428194.2011.621562
DO - 10.3109/10428194.2011.621562
M3 - Article
C2 - 21913806
AN - SCOPUS:84863137986
SN - 1042-8194
VL - 53
SP - 445
EP - 450
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 3
ER -
