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Mitoxantrone in relapsed or refractory acute nonlymphocytic leukemia
J J Vredenburgh1, O R McIntyre, G G Cornwell
1Department of Medicine, Dartmouth-Hitchhock Medical Center, Hanover, NH.
Abstract:
Seventeen patients with relapsed or refractory acute nonlymphocytic leukemia were treated with 14 mg/m2 of mitoxantrone given in a 30-minute infusion daily for three days. If the day fourteen bone marrow showed residual leukemia, a second course was given at the same dose for two days. Eight patients (47%) entered complete remission. Three patients (17%) had a partial response, four (24%) did not respond, and two (12%) died with hypoplastic marrows during treatment. Seven of the 12 relapsed patients entered a complete remission, as did one of the five refractory patients. Toxicity was acceptable; prolonged myelosuppression, moderate hepatic toxicity, and stomatitis were the only problems. Several dose schedules of mitoxantrone have been studied by other investigators with varying results. The three-day schedule in the present study is similar to the schedule used for common induction regimens employing anthracycline drugs. On the basis of its activity and acceptable toxicity in relapsed and refractory ANLL patients, we feel that this schedule could be safely combined with other agents in future studies.
Insights
Mitoxantrone showed effectiveness in treating relapsed or refractory acute nonlymphocytic leukemia (ANLL), with 47% of patients achieving complete remission. This three-day schedule demonstrated acceptable toxicity and potential for combination therapy in future ANLL studies.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Relapsed or refractory acute nonlymphocytic leukemia (ANLL) presents a significant therapeutic challenge.
- Limited effective treatment options exist for patients with relapsed or refractory ANLL.
Purpose of the Study:
- To evaluate the efficacy and toxicity of a specific mitoxantrone regimen in patients with relapsed or refractory ANLL.
- To determine the response rates and safety profile of a three-day mitoxantrone infusion schedule.
Main Methods:
- Seventeen patients with relapsed or refractory ANLL received mitoxantrone at 14 mg/m2 daily for three days.
- A second course was administered for two days if bone marrow showed residual leukemia on day fourteen.
- Toxicity was monitored, including myelosuppression, hepatic function, and stomatitis.
Main Results:
- Eight patients (47%) achieved complete remission (CR).
- Three patients (17%) had a partial response (PR).
- Seven of 12 relapsed patients and one of five refractory patients achieved CR. Toxicity was acceptable, with manageable myelosuppression, hepatic toxicity, and stomatitis.
Conclusions:
- The three-day mitoxantrone schedule demonstrates significant activity in relapsed and refractory ANLL.
- This regimen is associated with acceptable toxicity, suggesting its potential for combination therapy in future ANLL treatment strategies.