|
|
 Previous Article | Table of Contents | Next Article 
Treatment of poor risk acute leukemia with sequential high-dose ARA-C and
asparaginase
RL Capizzi, M Poole, MR Cooper, F Richards , JJ Stuart, DV Jackson , DR White, CL Spurr, JO Hopkins and HB Muss
Resistance of leukemia cells to cytosine arabinoside (ARA-C) may be due to
any one or combination of biochemical processes, which in certain instances
may be substantially reversed by an appropriate increase in ARA-C dosage.
Based on these and other laboratory observations indicating pharmacologic
synergy between sequential high-dose ARA-C and asparaginase
(HiDAC----ASNase), a therapeutic program was developed for the treatment of
patients with acute nonlymphocytic leukemia (ANLL) refractory to
conventional doses of ARA-C, as well as patients with high risk ANLL and
advanced acute lymphocytic leukemia (ALL). Treatment consisted of 3-hr
intravenous infusions of 3 g/sq m of ARA-C given at 12-hr intervals for 4
doses, followed by 6,000 IU/sq m ASNase given i.m. at hour 42. The same
schedule was repeated on day 8. In 32 induction attempts, only 4 patients
proved to be truly refractory, i.e., failed to achieve substantial leukemia
cell cytoreduction. Complete remissions were achieved with HiDAC---- ASNase
in 9 of 13 patients with refractory ANLL, 6 of 9 patients with antecedent
hematologic disorders, and 3 of 10 patients with advanced ALL. These
include 9 of 14 patients who had either failed induction or who had
relapsed on active ARA-C therapy and 6 of 8 patients who had had no prior
exposure to ARA-C. The median duration of unmaintained remission in ANLL
was 5 mo. In a patient with central nervous system (CNS) leukemia, there
was clearance of cerebral spinal fluid (CSF) blasts without intrathecal
therapy, suggesting a role for HiDAC in CNS prophylaxis. In general,
toxicity was tolerable and reversible. These data suggest that
HiDAC----ASNase is an exceptionally effective and well tolerated regimen in
leukemic patients with antecedent hematologic disorders and in those
refractory to conventional doses of ARA-C.
Volume 63,
Issue 3,
pp. 694-700,
03/01/1984
Copyright © 1984 by The American Society of Hematology
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
R. Aplenc, T. A. Alonzo, R. B. Gerbing, F. O. Smith, S. Meshinchi, J. A. Ross, J. Perentesis, W. G. Woods, B. J. Lange, and S. M. Davies
Ethnicity and survival in childhood acute myeloid leukemia: a report from the Children's Oncology Group
Blood,
July 1, 2006;
108(1):
74 - 80.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. H. Cragg, M. Andreeff, E. Feldman, J. Roberts, A. Murgo, M. Winning, M. B. Tombes, G. Roboz, L. Kramer, and S. Grant
Phase I Trial and Correlative Laboratory Studies of Bryostatin 1 (NSC 339555) and High-Dose 1-B-D-Arabinofuranosylcytosine in Patients with Refractory Acute Leukemia
Clin. Cancer Res.,
July 1, 2002;
8(7):
2123 - 2133.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Perel, A. Auvrignon, T. Leblanc, J.-P. Vannier, G. Michel, B. Nelken, V. Gandemer, C. Schmitt, J.-P. Lamagnere, L. De Lumley, et al.
Impact of Addition of Maintenance Therapy to Intensive Induction and Consolidation Chemotherapy for Childhood Acute Myeloblastic Leukemia: Results of a Prospective Randomized Trial, LAME 89/91
J. Clin. Oncol.,
June 15, 2002;
20(12):
2774 - 2782.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Buchner, W. Hiddemann, B. Wormann, H. Loffler, W. Gassmann, T. Haferlach, C. Fonatsch, D. Haase, C. Schoch, D. Hossfeld, et al.
Double Induction Strategy for Acute Myeloid Leukemia: The Effect of High-Dose Cytarabine With Mitoxantrone Instead of Standard-Dose Cytarabine With Daunorubicin and 6-Thioguanine: A Randomized Trial by the German AML Cooperative Group
Blood,
June 15, 1999;
93(12):
4116 - 4124.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Advani, H. I. Saba, M. S. Tallman, J. M. Rowe, P. H. Wiernik, J. Ramek, K. Dugan, B. Lum, J. Villena, E. Davis, et al.
Treatment of Refractory and Relapsed Acute Myelogenous Leukemia With Combination Chemotherapy Plus the Multidrug Resistance Modulator PSC 833 (Valspodar)
Blood,
February 1, 1999;
93(3):
787 - 795.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. M. Rowe and M. S. Tallman
Intensifying Induction Therapy in Acute Myeloid Leukemia: Has a New Standard of Care Emerged?
Blood,
September 15, 1997;
90(6):
2121 - 2126.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. J. Durivage and N. L. Burnham
Prevention and Management of Toxicities Associated With Antineoplastic Drugs
Journal of Pharmacy Practice,
January 1, 1991;
4(1):
27 - 48.
[PDF]
|
|
|
|
|
