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The majority of patients with acute myeloid leukemia (AML) are elderly, and their response to chemotherapy is poorer than that of younger patients. The combination of mitoxantrone (MTN) and cytosine arabinoside (Ara-C) is a possible alternative to an anthracycline/Ara-C combination for the treatment of AML in these patients. Of 52 older patients (> 59 years) referred over a 3.5-year period, 33 patients (age range 60-78 years, median 67 years) received MTN and Ara-C as therapy for newly diagnosed AML. MTN was administered at a dose of 12 mg/m2/day, intravenously, for 3 days (23 patients), or 10 mg/m2/day for 5 days (10 patients), and Ara-C at a dose of 100 mg/m2 twice daily, intravenously, for 7 days. Complete remission (CR) was achieved in 16/33 patients (48%). The median remission duration was 6 months (range 1-37 months). The median survival was 14 months for those who achieved CR compared with 9 months for those with resistant disease. Two patients remain in first CR after 13 and 37 months, but three patients died whilst receiving consolidation therapy. In selected elderly patients with AML, the combination of MTN and Ara-C provides an acceptable alternative to an anthracycline/Ara-C regimen, with a higher CR rate than historical controls. However, the CR rate and remission duration remain low compared with those of younger patients, supporting the need to investigate new approaches to treatment in this population.

Original publication

DOI

10.1007/s002770050080

Type

Journal article

Journal

Annals of hematology

Publication Date

07/1995

Volume

71

Pages

35 - 39

Addresses

Department of Hematology, St. Bartholomew's Hospital, West Smithfield, London, UK.

Keywords

Blood Platelets, Neutrophils, Humans, Mitoxantrone, Cytarabine, Antineoplastic Combined Chemotherapy Protocols, Leukocyte Count, Remission Induction, Drug Administration Schedule, Survival Analysis, Age Factors, Aged, Middle Aged, Female, Male, Leukemia, Myeloid, Acute