Induction Therapy for Acute Myelogenous Leukemia in Patients Over 60 Years with Intermediate-Dose Cytosine Arabinoside, Mitoxantrone and Etoposide

Abstract

Twenty-three patients greater than age 60 years with acute myelogenous leukemia (AML) received induction therapy with continuous infusion cytosine arabinoside (1.5 g/m²/day, day 1-3), mitoxantrone (10 mg/m²/day, day 1-3) and etoposide (800 mg/m², day 4). Patients entering complete remission (CR) were eligible to receive an identical consolidation cycle. Eighteen of the 23 patients (78%; 95% confidence interval 56% to 93%) entered CR. Twelve of these received consolidation therapy and 4 of these remain in remission at 3 to 20 months. Hematologic toxicity of the regimen was acceptable; only 1 patient died following therapy (having attained a CR). Non-hematologic toxicity was mostly mild (grade 2 or less) with one episode of grade 3 cerebellar toxicity. While this regimen induces a high CR rate in patients > age 60 years, relapses remain common and overall survival is too early to assess.

Key Words:

• AML
• elderly
• ara-C
• mitoxantrone
• etoposide