Daenen S, Löwenberg B, Sonneveld P, van Putten W L, Verhoef G, Verdonck L F, van Veldhoven M, Huijgens P C
University of Groningen, The Netherlands.
Leukemia. 1994 Jan;8(1):6-10.
Thirty-seven newly diagnosed patients with acute myeloid leukemia (AML) who were not in complete remission (CR) after induction chemotherapy with cytarabine and daunorubicin followed by intermediate-dose cytarabine and amsacrine, were treated with mitoxantrone and etoposide in a prospective, open multicenter study. The aim was to examine the efficacy and the toxicity of mitoxantrone and etoposide in a patient population with bad prognosis because of refractoriness to two standardized induction courses. Twelve patients attained CR (32.4%). Responders were found only among the patients with documented susceptibility (i.e. partial remission) to the previous therapy. In responding patients the median remission duration and disease-free survival was 15+ months (range 3-52+). Toxicity was mainly hematologic and characterized by prolonged hypoplasia; one patient died in aplasia. Granulocytes and platelets recovered unexpectedly early in six of 22 non-responders. This study suggests that AML patients refractory to two standardized chemotherapy courses can still attain a durable CR after an additional course, here with mitoxantrone and etoposide, provided they show some responsiveness to the previously given cytostatic drugs.
37例新诊断的急性髓系白血病（AML）患者，在接受阿糖胞苷和柔红霉素诱导化疗后未达到完全缓解（CR），随后接受中剂量阿糖胞苷和安吖啶治疗，在一项前瞻性、开放性多中心研究中接受米托蒽醌和依托泊苷治疗。目的是在因对两个标准化诱导疗程难治而预后不良的患者群体中，研究米托蒽醌和依托泊苷的疗效及毒性。12例患者达到CR（32.4%）。仅在对先前治疗有记录的敏感性（即部分缓解）的患者中发现有反应者。在有反应的患者中，中位缓解持续时间和无病生存期为15 +个月（范围3 - 52 +）。毒性主要为血液学毒性，表现为长期造血功能低下；1例患者死于再生障碍。22例无反应者中有6例粒细胞和血小板意外地恢复得很早。本研究表明，对两个标准化化疗疗程难治的AML患者，若对先前给予的细胞毒性药物有一定反应性，在追加一个疗程（此处为米托蒽醌和依托泊苷）后仍可获得持久的CR。
