Treatment of acute leukemia with amsacrine and high-dose cytarabine

We varied the number of doses of high-dose cytarabine (3 g/m2) given to patients with acute leukemia in relapse who were receiving therapeutic doses of amsacrine (600 mg/m2/course). Twelve patients received 13 courses of therapy. Two of six patients with acute nonlymphocytic leukemia and one of three with acute lymphoblastic leukemia achieved remission. Dose-limiting toxicity (diarrhea) was seen in patients receiving more than five daily doses of high-dose cytarabine. We conclude that therapeutic doses of amsacrine can be combined safely with five daily doses of high-dose cytarabine and that a formal study is now required to assess the efficacy of this regimen.