Cytarabine with high-dose mitoxantrone induces rapid complete remissions in adult acute lymphoblastic leukemia without the use of vincristine or prednisone Journal Article
| Authors: | Weiss, M.; Maslak, P.; Feldman, E.; Berman, E.; Bertino, J.; Gee, T.; Megherian, L.; Seiter, K.; Scheinberg, D.; Golde, D. |
| Article Title: | Cytarabine with high-dose mitoxantrone induces rapid complete remissions in adult acute lymphoblastic leukemia without the use of vincristine or prednisone |
| Abstract: | Purpose: To evaluate the efficacy and safety of a new induction regimen for adult acute lymphoblastic leukemia (ALL) that does not contain vincristine or corticosteroids. Patients and Methods: Thirty-seven adult patients with newly diagnosed ALL and lymphoblastic lymphoma were treated with a dose-intense induction regimen. This regimen was designed to increase the fraction of patients achieving an early complete remission (CR) in an attempt to increase long-term disease-free survival. The induction regimen was cytarabine (Ara-C) 3 g/m2/d for 5 days and mitoxantrone 80 mg/m2 as a single dose on day 3. Granulocyte colony-stimulating factor (G-CSF) 200 μg/m2/d beginning on day 7 was used to promote early myeloid recovery. Results: There were 31 CRs (84%). Median time to CR was 34 days, median hospital stay was 28 days, and the median number of days with a neutrophil count less than 500/μL was 18. There were three patients with resistant disease who experienced treatment failure and three early deaths from sepsis. Four patients with Philadelphia chromosome-positive (Ph+) ALL achieved hematologic and cytogenetic CRs. Conclusion: This dose-intense induction regimen produced a high incidence of CRs with acceptable toxicity without the use of vincristine or corticosteroids. Comparisons with our prior vincristine/prednisone-based induction regimen (the L-20 protocol) suggest that patients treated on the current study were more likely to achieve a CR and that they achieved this remission earlier than patients treated with a traditional four-drug (vincristine, prednisone, doxorubicin, and cyclophosphamide) induction regimen. |
| Keywords: | adolescent; adult; clinical article; controlled study; aged; disease-free survival; middle aged; prednisone; dose response; cytarabine; antineoplastic combined chemotherapy protocols; vincristine; acute lymphoblastic leukemia; survival time; hospitalization; cancer regression; mitoxantrone; remission induction; sepsis; leukocyte count; granulocyte colony stimulating factor; granulocyte colony-stimulating factor; humans; human; male; female; priority journal; article; leukemia, lymphocytic, acute, l2 |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 14 |
| Issue: | 9 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1996-09-01 |
| Start Page: | 2480 |
| End Page: | 2485 |
| Language: | English |
| PUBMED: | 8823326 |
| PROVIDER: | scopus |
| DOI: | 10.1200/JCO.1996.14.9.2480 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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