RT Journal Article
SR Electronic
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
FD International Institute of Anticancer Research
SP 1347
OP 1353
VO 32
IS 4
A1 TOSHIHIRO FUKUSHIMA
A1 HIROSHI KAWABATA
A1 TOSHIOKI SAWAKI
A1 TOMOMI SATOH
A1 TAKUJI NAKAMURA
A1 HARUKA IWAO
A1 AKIO NAKAJIMA
A1 TOMOYUKI SAKAI
A1 MIYUKI MIKI
A1 YOSHIMASA FUJITA
A1 MASAO TANAKA
A1 TAKAFUMI KAWANAMI
A1 YASUFUMI MASAKI
A1 TOSHIRO OKAZAKI
A1 HISANORI UMEHARA
YR 2012
UL http://ar.iiarjournals.org/content/32/4/1347.abstract
AB 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.