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Acridinyl anisidide (m-AMSA) therapy in 11 patients with refractory acute leukemia
Abstract:
Eleven patients with acute leukemia, refractory to all previous chemotherapy, were treated with acridinyl anisidide (m-AMSA). Seven patients received m-AMSA i.v. as a single agent at 150 mg/m2 daily for 4 to 7 days, and 4 patients received m-AMSA at 90 mg/m2 daily for 3 days in combination with thioguanine and cytosine arabinoside. Four of the nine patients with acute nonlymphoblastic leukemia responded to the treatment, and complete remission was obtained in three of them. One of these patients remained in complete remission 5 months after therapy. Three of the four responding patients received m-AMSA as a single agent. Two patients with resistant acute lymphoblastic leukemia did not respond. As in earlier trials with m-AMSA reported by others, about one-third of our refractory patients responded, which justifies the future use of this agent in refractory leukemia and in other regimens for the induction of remission in acute leukemia. Despite minimal cardiotoxicity of the drug, evidence of its cardiotoxic potential is recorded.
Insights
Acridinyl anisidide (m-AMSA) showed promise in treating refractory acute leukemia. Approximately one-third of patients responded, with some achieving complete remission, indicating its potential in future leukemia treatment regimens.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Acute leukemia often becomes refractory to standard chemotherapy.
- Novel therapeutic agents are needed for patients with refractory leukemia.
- Acridinyl anisidide (m-AMSA) is an investigational antineoplastic agent.
Purpose of the Study:
- To evaluate the efficacy and safety of acridinyl anisidide (m-AMSA) in patients with refractory acute leukemia.
- To assess response rates and duration of remission.
- To document any cardiotoxic effects of m-AMSA.
Main Methods:
- Eleven patients with refractory acute leukemia were treated with m-AMSA.
- Seven patients received intravenous m-AMSA as a single agent (150 mg/m2 daily for 4-7 days).
- Four patients received m-AMSA (90 mg/m2 daily for 3 days) in combination with thioguanine and cytosine arabinoside.
Main Results:
- Four of nine patients with acute nonlymphoblastic leukemia responded to m-AMSA treatment.
- Three of the responding patients achieved complete remission, with one maintaining remission for 5 months.
- Two patients with acute lymphoblastic leukemia did not respond; cardiotoxicity was minimal but noted.
Conclusions:
- Acridinyl anisidide (m-AMSA) demonstrates activity in a subset of patients with refractory acute leukemia.
- The response rate of approximately one-third supports further investigation of m-AMSA in leukemia treatment.
- m-AMSA may be valuable in salvage therapy and in combination regimens for acute leukemia induction.