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Homoharringtonine therapy induces responses in patients with chronic
myelogenous leukemia in late chronic phase
S O'Brien, H Kantarjian, M Keating, M Beran, C Koller, LE Robertson, J Hester, MB Rios, M Andreeff and M Talpaz
Department of Hematology, University of Texas MD Anderson Cancer Center,
Houston 77030, USA.
Homoharringtonine (HHT) is a plant alkaloid with potent myelosuppressive
activity and little toxicity when used in a continuous infusion schedule.
The antileukemic efficacy of HHT has been shown in acute myeloid leukemia,
but has not been investigated in chronic myelogenous leukemia (CML).
Seventy-one patients with Philadelphia chromosome-positive (Ph+) CML in
late chronic phase (time from diagnosis to therapy longer than 12 months)
were treated with a continuous infusion of HHT at a daily dose of 2.5 mg/m2
for 14 days for remission induction and for 7 days every month for
maintenance. The median number of courses given was 6 (range, 1 to 35) and
21 patients (30%) continue on treatment. Forty-two of 58 patients (72%)
evaluable for hematologic response achieved a complete hematologic
remission, and 9 (16%) had a partial hematologic remission. Twenty-two of
71 patients (31%) developed a cytogenetic response; it was major (Ph+ cells
less than 35%) in 11 (15%) and complete (Ph+ cells 0%) in 5 (7%).
Significant myelosuppression occurred in 39% of induction courses and 9% of
maintenance courses. Fever or documented infection was present in 26% of
induction courses and in only 8% of maintenance courses.
Nonmyelosuppressive toxicity was minimal. Homoharringtonine produced
hematologic remissions in the majority of patients with advanced
chronic-phase CML. Cytogenetic response occurred in some patients without
an association with myelosuppression, and these responses may be prolonged.
Future studies investigating homoharringtonine in combination with other
active agents in CML, such as interferon, are warranted.
Volume 86,
Issue 9,
pp. 3322-3326,
11/01/1995
Copyright © 1995 by The American Society of Hematology
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