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High-dose ara-C in older adults with acute leukemia
1Bone Marrow Transplant Program, University of Louisville School of Medicine, Cincinnati, Ohio, USA.
Abstract:
The concept of high-dose ara-C (HIDAC) was introduced 15 years ago. Phase I studies established a maximum tolerated dose of 3 g/m2, given every 12 hours for 12 doses. Because dermatologic, gastrointestinal, and central nervous system toxicities were dose-limiting in patients over age 50, a reduction from the maximal dose was suggested. Initial studies with refractory or resistant acute myelogenous leukemia (AML), with or without anthracyclines, demonstrated a significant antileukemic effect of HIDAC, with about 60 percent of patients achieving a complete response. Studies by our group and others have established that older patients can be successfully treated with HIDAC, probably with some added benefit in combining dose-intensive regimens.