Seven day cytosine arabinoside administered subcutaneously plus daunorubicin for remission induction in AML

51 patients (mean age 40, range 17-71) with previously untreated AML (25% of M4-6 FAB type) were given Ara-C subcutaneously 100 mg/m2 every 12 h for 7 days and DNR 45 mg/m2 on days 1-3 i.v. for inducing remission. After 52 days 49% of patients on an average reached CR. The complete responders were given a 5 day treatment pulses monthly until relapse, which consisted of Ara-C s.c. plus one of the following drugs added in cyclic rotation: 6-TG, cyclophosphamide, CCNU or DNR. After 2 years the intervals between cycles were prolonged step by step. The mean/median of CR duration equals 26/19 months and of the survival of complete responders 32.9/27 months. The relapse rate and the CNS relapse rate equaled 1.9% and 0.36% per patient/month of observation. T and B cell depletion was observed during maintenance. The results indicate that the subcutaneous route of administering Ara-C is effective during the induction of remission.