m-AMSA: phase II trial in advanced lymphoma and leukemia

m-AMSA, an acridine dye derivative, has been utilized in 36 patients with advanced hematologic malignancies. In 22 patients with lymphoma receiving 120 mg/m2 every 3 weeks, 10(45%) have achieved remissions. Eight of these remissions have been partial. The median duration of remission in patients with lymphoma was 3 months (range 1-12+ months). In 11 patients with acute leukemia receiving m-AMSA, 40 mg/m2 t.i.d. for 5 days, three (27%) have achieved remissions. Two of the three remissions have been complete. All three remissions in patients with leukemia were sustained for 1 month. Two patients with myeloma and one patient with chronic lymphocytic leukemia failed to respond. The major toxicity of m-AMSA has been myelosuppression. The dose-limiting toxic effect in patients with lymphoma was neutropenia. Nausea and vomiting, alopecia, phlebitis, and hepatic dysfunction have been noted in a minority of patients. Phlebitis appeared to be prevented with heparin administration after m-AMSA infusion. One fatal arrhythmia occurred, apparently related to therapy. m-AMSA appears active in advanced leukemia and lymphoma. Further studies are merited, particularly in combination with known effective agents, in order to improve upon remission duration.