[Adriamycin-aclacinomycin therapy (AA therapy) for acute leukemia unresponsive to BH-AC-DMP therapy]

Eight adults with acute non-lymphocytic leukemia refractory to BH-AC.DMP therapy (N4-behenoyl-1-beta-D-arabinofuranosylcytosine, daunomycin, 6-mercaptopurine and prednisolone) were treated with a combination therapy of anthracycline antibiotics: adriamycin and aclacinomycin A (AA therapy). Four of five patients, who had received neither adriamycin nor aclacinomycin A previously, achieved complete remission after one course of AA therapy with a median time to remission of 24.5 days (ranging from 21 to 31 days). Two cases were in first remission induction phase and the other two were in first of third relapse. Three cases still maintain complete remission and the durations of remission range from 3 to over 14 months. Major side effects were loss of hair (100%) and myocardial damage (64%). T wave flattening and appearance of U wave in ECG were noted a few days after receiving chemotherapy but those changes returned to normal within 2 to 3 weeks. Ventricular fibrillation was observed in one case, which was refractory to chemotherapy and complicated by sepsis and electrolytes imbalance. Thus, this regimen deserves to be tried as a remission induction in patients with refractory acute non-lymphocytic leukemia.