Salvage therapy of refractory and relapsed acute leukemia with high dose mitoxantrone and high dose cytarabine

Abstract 

We have assessed the outcome of 66 refractory and relapsed acute leukemia patients treated with high dose mitoxantrone and cytarabine. Therapy consisted of a total dose of 40–60 mg/m² mitoxantrone and 3 g/m² of cytarabine daily on 5 consecutive days. A total of 28 patients were treated for primary resistant and 38 patients for early or late relapsed leukemia. A total of 35 patients achieved CR. Four patients died during the induction course. Toxicity was acceptable and comparable to other salvage regimens. The median disease-free and overall survivals were 4 and 6 months, respectively. Although this regimen is effective in achieving remission in refractory leukemia, its duration is short.

Keywords: Salvage, Acute leukemia, Mitoxantrone, HIDAC, Refractory, Relapsed

Abbreviations: CR, complete remission, PR, partial remission, NR, no response, DFS, disease free survival, OS, overall survival, AML, acute myeloid leukemia, ALL, acute lymphoblastic leukemia, HIDAC, high dose cytarabine, BFM, Berlin-Frankfurt-Munster, WHO, world health organization, BMT, bone marrow transplantation