MEC (mitoxantrone, etoposide, and cytarabine) induces complete remission and is an effective bridge to transplant in acute myeloid leukemia

Abstract

Introduction Clinical response and chemosensitivity of relapse or refractory AML patients were evaluated after rescue and bridge‐to‐transplant MEC (mitoxantrone, etoposide, and cytarabine) regimen. Methods and Patients Fifty‐five consecutive AML patients were treated with MEC from 2009 to 2018. Chemosensitivity was evaluated by WT1 quantification. Results 27/55 patients (49.1%) had AML resistant to induction and 28/55 patients (50.9%) had AML relapse. 25/55 patients (45.5%) achieved a CR after one course of MEC, and 12 patients (21.8%) achieved WT1 negativity. In 12 patients, a second MEC was administered. Four out of 12 patients improved significantly their response with the 2nd MEC. MEC was an effective bridge to transplant, 32/55 patients (58.2%) received an allogenic stem cell transplant. Median overall survival (OS) from MEC was 455 days (95% CI 307‐602 days.); patient with WT1 negative CR had the best OS (P<.000). Conclusion WT1 is a useful marker of chemosensitivity after MEC as rescue and bridge‐to‐transplant therapy.

Fludarabine, cytarabine, and idarubicin with or without venetoclax in patients with relapsed/refractory acute myeloid leukemia

“…3 Salvage treatment with intensive chemotherapy regimens like fludarabine, cytarabine, and idarubicin (FLA-IDA), high-dose cytosine arabinoside and mitoxantrone (HAM), or mitoxantrone, etoposide and intermediate-dose Ara-C (MEC) induce CR in 35-58%, and median overall survival (OS) of 6.5-11.9 months in patients undergoing alloHCT and of 1.5-11.9 months in patients not eligible for alloHCT. [4][5][6][7][8][9] Lower-intensity regimens combining the B-cell lymphoma-2 (BCL-2) inhibitor venetoclax and hypomethylating agents (HMA) or low-dose cytarabine (LDAC) demonstrated high efficacy in AML. [10][11][12] Based on the results of the VIALE-A trial venetoclax combined with HMA is approved for newly diagnosed patients with AML who are 75 years old, or unfit for intensive chemotherapy providing a new robust standard of care option for this frail population.…”

In Silico Molecular Dynamics Docking of Drugs to the Inhibitory Active Site of SARS-CoV-2 Protease and Their Predicted Toxicology and ADME

“…Etoposide (Rank 56, BE=-8.6, B00773) is for use in combination with other chemotherapeutic agents in the treatment of refractory testicular tumors and as first line treatment in patients with small cell lung cancer. Also used to treat other malignancies such as lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme [93][94][95][96] . Ouabain (Rank 60, BE=-8.6, B01092) is indicated for treatment of atrial fibrillation and flutter and heart failure [97][98][99][100][101][102] , and has been investigated in oncology [93,103] .…”

The Applications of Mitoxantrone and Its Liposome in Adult Acute Myeloid Leukemia

“…In this study, MTZ chemotherapy schedule provided for better complete response rates (MTZ 47% vs DNR 38%), however, overall survival and DFS probabilities did not improve. Marconi et al [24] collected data of 55 patients who had an AML relapse or chemotherapy resistance received MEC (mitoxantrone, etoposide, cytarabine) chemotherapy. Twenty-five patients (45.4%) achieved CR and four patients (7.3%) died, which showed similar outcomes like above.…”