TY - JOUR T1 - Low-dose Cytarabine plus Aclarubicin for Patients with Previously Untreated Acute Myeloid Leukemia or High-risk Myelodysplastic Syndrome Ineligible for Standard-dose Cytarabine plus Anthracycline JF - Anticancer Research JO - Anticancer Res SP - 1347 LP - 1353 VL - 32 IS - 4 AU - TOSHIHIRO FUKUSHIMA AU - HIROSHI KAWABATA AU - TOSHIOKI SAWAKI AU - TOMOMI SATOH AU - TAKUJI NAKAMURA AU - HARUKA IWAO AU - AKIO NAKAJIMA AU - TOMOYUKI SAKAI AU - MIYUKI MIKI AU - YOSHIMASA FUJITA AU - MASAO TANAKA AU - TAKAFUMI KAWANAMI AU - YASUFUMI MASAKI AU - TOSHIRO OKAZAKI AU - HISANORI UMEHARA Y1 - 2012/04/01 UR - http://ar.iiarjournals.org/content/32/4/1347.abstract N2 - Background: In order to assess the role of the combination of low-dose cytarabine (Ara-C) plus aclarubicin (CA) in remission induction for patients with untreated acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS), we retrospectively analyzed the efficacy and safety of CA. Patients and Methods: Data of twenty patients with untreated AML or high-risk MDS who were ineligible for standard-dose Ara-C plus anthracycline and received CA as remission-induction therapy were analyzed. CA consisted of low-dose Ara-C (10 mg/m2, subcutaneous injection every 12 hours, for 14 days) and aclarubicin (14 mg/m2 for patients <70 years old and 10 mg/m2 for patients ≥70 years old in a one-hour infusion for 4 days). Granulocyte colony-stimulating factor (G-CSF) was used from day 1 of CA to white blood cell count (WBC) recovery, except for patients with initial WBC of more than 20.0×103/mm3. Results: Eleven patients (55%) achieved complete remission. All four patients whose WBC were ≥20.0×103/mm3 and did not receive G-CSF were refractory to CA. The predicted 2-year overall survival rate and median survival duration of all 20 patients were 37.9% and 363 days, respectively. The predicted 1-year relapse-free survival (RFS) rate and median duration of RFS of 11 patients who achieved complete remission were 30.3% and 332 days, respectively. Only one patient died due to transfusion-related acute lung injury. No patients died due to severe infections. Conclusion: CA combination with G-CSF as remission-induction therapy is promising and well-tolerated in patients with previously untreated AML or high-risk MDS who are ineligible for standard-dose Ara-C plus anthracycline without leukocytosis. In order to improve RFS, intensive postremission chemotherapy or allogeneic hematopoietic stem cell transplantation should be introduced. ER -