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Preliminary Experience with Short Course High-Dose Mitoxantrone in Combination with High-Dose Cytarabine in Patients
E J Feldman1, S Biguzzi1, T Ahmed1
1a Department of Medicine, Division of Neoplastic Diseases, New York Medical College, Valhalla, NY.
Abstract:
Mitoxantrone is effective therapy for patients with acute leukemia and blastic phase of chronic myelogenous leukemia (CML). In vitro mitoxantrone has a steep dose response curve, which suggests that higher doses given in a shorter duration may result in enhanced leukemic cell kill in vivo. Twenty-four patients with acute leukemia and blastic CML received mitoxantrone 20 mg/m2 I.V. daily × 2 with cytarabine 3 g/m2 I.V. once daily × 5 days. Diagnoses included 8 patients with previously untreated acute non-lymphocytic leukemia (ANLL), 9 patients with relapsed ANLL, 4 patients with refractory acute lymphoblastic leukemia (ALL) and 2 patients with blastic CML. Complete remission was achieved in 8 of 17 patients with ANLL, 1 of 4 patients with ALL and 0 of 2 with blastic CML. Extramedullary toxicity was acceptable and the median time to remission was 26 days (range 20-69). Short course high-dose mitoxantrone with high-dose cytarabine is effective and well-tolerated in patients with acute leukemia.
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