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Etoposide in leukemia.

J F Bishop1, R Lowethal, D Joshua

  • 1Department of Hematology and Medical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.

Cancer
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

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Etoposide combined with standard chemotherapy improved remission duration for acute nonlymphocytic leukemia (ANLL) patients. Younger patients also showed improved survival with the etoposide-containing regimen, despite increased toxicity during consolidation.

Area of Science:

  • Hematology
  • Medical Oncology
  • Clinical Pharmacology

Background:

  • Etoposide demonstrates activity as a single agent in acute nonlymphocytic leukemia (ANLL).
  • Combination chemotherapy regimens are utilized for salvage and consolidation in ANLL.

Purpose of the Study:

  • To evaluate the efficacy of adding etoposide to a standard induction chemotherapy regimen for previously untreated ANLL patients.
  • To compare remission duration and survival rates between standard chemotherapy and an etoposide-containing regimen.

Main Methods:

  • A randomized trial assigned 264 ANLL patients (15-70 years) to cytarabine plus daunorubicin (7-3) or the same regimen plus etoposide (7-3-7).
  • Patients achieving complete response (CR) received consolidation therapy.
  • Remission duration and survival were analyzed, with a subset analysis for patients under 55 years.

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Main Results:

  • Complete response rates were similar (56% for 7-3 vs. 59% for 7-3-7).
  • The etoposide-containing regimen (7-3-7) significantly improved remission duration (18 vs. 12 months).
  • In patients younger than 55, 7-3-7 also significantly improved survival (17 vs. 9 months) and remission duration (27 vs. 12 months).
  • Hematologic toxicity was more severe with 7-3-7 during consolidation.

Conclusions:

  • Etoposide is an active agent in ANLL induction therapy.
  • Adding etoposide to induction chemotherapy prolongs remission duration and, in younger patients, survival.
  • The benefits of etoposide must be weighed against increased consolidation toxicity.