Fludarabine and cytarabine as continuous sequential infusion for elderly patients with acute myeloid leukemia.

Abstract:

BACKGROUND AND OBJECTIVES:A phase II study was conducted to investigate the effects of a therapeutic program based on the combination of fludarabine and cytarabine (ARA-C) administered as a sequential continuous infusion in untreated elderly patients with acute myeloid leukemia (AML). DESIGN AND METHODS:Sixty-three patients with non-M3 AML, median age 69 years (range 61-81), were accrued. Twenty-four patients (38%) had AML secondary to myelodysplastic syndrome. Fludarabine and ARA-C were administered as a continuous sequential infusion for 72 and 96 hours, respectively, after a loading dose. Patients achieving complete remission (CR) were intended to receive an additional course, followed by autologous stem cell transplantation (ASCT). RESULTS:Overall, 42 patients (67%) achieved CR. There were 10 induction deaths (16%), while 11 patients were refractory (17%). Among those achieving a remission, 35 patients (83%) received the planned consolidation course and 29 underwent mobilization of CD34+ cells into the peripheral blood for collection, which was successful in 23 (79%). Overall, 17 patients (27% of the whole population) received ASCT. The median overall and disease-free survival were both 10 months. INTERPRETATION AND CONCLUSIONS:Patients with an intermediate karyotype and those receiving ASCT had a significantly better clinical outcome. Results in terms of CR achievement, CD34+ cell collection and ASCT feasibility. A longer follow up is needed in order to evaluate the actual benefit on long-term survival.

journal_name

Haematologica

journal_title

Haematologica

authors

Ferrara F,D'Arco AM,De Simone M,Mele G,Califano C,Pocali B,Danise P,Palmieri S

keywords:

subject

Has Abstract

pub_date

2005-06-01 00:00:00

pages

776-84

issue

6

eissn

0390-6078

issn

1592-8721

journal_volume

90

pub_type

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