Maschmeyer G, Willborn K, Heit W
Department of Internal Medicine, Hematology and Oncology, Evangelisches Krankenhaus Essen-Werden, Germany.
Leuk Lymphoma. 1992 Nov;8(4-5):365-9. doi: 10.3109/10428199209051016.
Forty-eight patients with acute myelogenous leukemia (AML) not eligible for anthracycline or mitoxantrone treatment, mostly due to cardiac contraindications, were given aggressive therapy using m-amsacrine (AMSA) in combination with conventional or high-dose cytarabine for remission induction. Twenty-nine patients (60.4%) responded to treatment, and complete remission was attained in 19 (39.6%), partial remission in 4 (8.3%) and death in bone marrow aplasia without detectable blasts in 6 patients (12.5%). Median time to granulocyte recovery was 32 days, median duration of relapse-free survival 199 days. One patient experienced a serious cardiac adverse event; nausea and vomiting were observed in 73%, diarrhea in 44%, and hepatoxicity in 29% of patients. All potentially AMSA-related side effects were fully reversible, and a lethal complication did not occur. It is concluded that combination chemotherapy with AMSA and Ara-C is also effective and tolerable in leukemic patients in whom cardiotoxic drugs are contraindicated.
48例急性髓性白血病（AML）患者因大多存在心脏禁忌证而不符合使用蒽环类药物或米托蒽醌治疗的条件，这些患者接受了以安吖啶（AMSA）联合传统剂量或大剂量阿糖胞苷进行缓解诱导的强化治疗。29例患者（60.4%）对治疗有反应，19例（39.6%）达到完全缓解，4例（8.3%）部分缓解，6例患者（12.5%）死于骨髓再生障碍且未检测到原始细胞。粒细胞恢复的中位时间为32天，无复发生存的中位持续时间为199天。1例患者发生严重心脏不良事件；73%的患者出现恶心和呕吐，44%的患者出现腹泻，29%的患者出现肝毒性。所有可能与AMSA相关的副作用均可完全逆转，且未发生致命并发症。结论是，对于禁忌使用心脏毒性药物的白血病患者，AMSA与阿糖胞苷联合化疗也是有效且可耐受的。
