High-dose cytosine arabinoside and daunorubicin as consolidation therapy
for acute nonlymphocytic leukemia in first remission: a pilot study
SN Wolff, J Marion, RS Stein, JM Flexner, HM Lazarus, TR Spitzer, GL Phillips, RH Herzig and GP Herzig
High-dose (HD) cytosine arabinoside (ARA-C) is more effective treatment
than conventional-dose ARA-C regimens for patients with relapsed acute
nonlymphocytic leukemia (ANLL). We report here that HD ARA-C given during
the first remission of ANLL has resulted in long remission durations and a
high proportion of patients who survive more than three years free of
disease. From August 1979 to September 1983, 36 adult patients with ANLL in
first remission received one to three courses of HD ARA-C (3 g/m2 by
one-hour infusion every 12 hours for 12 doses on days 1 through 6) alone or
with daunorubicin (30 mg/m2 for two or three doses on days 7 through 9).
Three patients died of sepsis or hemorrhage during consolidation, and 14
patients have relapsed from five to 48 months after diagnosis. The
remaining 19 patients are in continued complete remission (CCR) from 11 to
62 months. Denoting all deaths in remission as relapse, the actuarial
probability of CCR is 42% at 62 months, with an apparent plateau in the
survival curve. Of the first 22 patients treated, ten remain in CCR from 37
to 62 months with no therapy for at least three years. Due to its
heightened anti-leukemic activity, HD ARA-C allows brief but effective
consolidation of ANLL in first remission, with long-term disease-free
survival comparable to other approaches.
Volume 65,
Issue 6,
pp. 1407-1411,
06/01/1985
Copyright © 1985 by The American Society of Hematology
