[Short Course High Dose Mitoxantrone with Cytarabine for Treatment of Refractory and Relapsed Acute Leukemia]

Although chemotherapy can achieve a high rate of disease remission in patients with newly diagnosed acute leukemia, patients with recurrent or refractory leukemia generally have a poorer rate of response. This study was designed to assess the utility of high-dose mitoxantrone and intermediate-dose cytarabine in the treatment of patients with relapsed or refractory acute leukemia. Thirty patients with relapsed or refractory acute leukemia were treated with mitoxantrone at a total dose of 40 mg/m(2) intravenously and cytarabine 1 - 1.5 g/m(2) over 3 hours once daily for five doses. Twenty-six of thirty patients achieved complete response (CR 87%) and one achieved partial response (PR 3.3%). No patient died during the induction course. The main toxic effect was hematopoietic suppression that was clinically acceptable. The median time needed for CR was around 30 days. The median disease-free and overall survival times were 3.5 and 6 months, respectively. The results demonstrate that short course high-dose mitoxantrone with cytarabine is associated with a trend toward a higher CR rate and therefore, it should be an effective antileukemic regimen for the treatment of refractory and relapsed acute leukemia.