Oral idarubicin in the treatment of acute myelogenous leukaemia and the blast phase of chronic myeloid leukaemia

Malik, S. T. A.; Tucker, J.; Rohatiner, A. Z. S.; Brace, W; Lister, T. Andrew

doi:10.1002/hon.2900070605

Cited by 16 publications

(2 citation statements)

References 2 publications

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“…Idarubicin has also been used in an intravenous combination with etoposide (Carella et al, 1989). The peroral form has been employed either as a single drug (Lambertenghi-Deliliers et al, 1986;Lowenthal et al, 1987;Harousseau et al, 1989;Malik et al, 1989) or in combination with cytarabine (Falkson et al, 1986) in the treatment of acute leukemia with promising results. Oral idarubicin has been given as a single drug in myelodysplastic syndromes and subsequent acute leukemia, and some good responses have been seen ( De Bock et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

Etoposide, 6‐thioguanine and idarubicin, an oral combination regimen (ETI) for the induction treatment of acute leukemia

Ruutu

Elonen

1991

Hematological Oncology

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Twenty patients with advanced acute leukemia (16 acute myeloid leukemia (AML), three myeloid blast crisis (BC) of chronic myeloid leukemia (CML), one acute lymphatic leukemia) were treated with a peroral regimen consisting of etoposide 80 mg/m2 and 6-thioguanine 100 mg/m2 twice daily for 5 days, and idarubicin 15 mg/m2 once daily for 3 days (ETI). Two AML patients were in first relapse. All the other patients with acute leukemia had a later relapse or were refractory to primary or salvage treatment. One to six ETI cycles were given. Four AML patients achieved remission and one patient with BC of CML entered the second chronic phase. Clearing of the blood of leukemic cells was seen in seven additional patients. Infection was the most common complication, gastrointestinal toxicity was not a major problem. In conclusion, peroral ETI treatment has a marked antileukemic effect even in an advanced disease, and the toxicity is moderate and well acceptable.

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Section: Discussionmentioning

confidence: 99%

Etoposide, 6‐thioguanine and idarubicin, an oral combination regimen (ETI) for the induction treatment of acute leukemia

Ruutu

Elonen

1991

Hematological Oncology

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“…The CR rates ranged between 22% and 40% according to the dose. [10][11][12] Oral ZVD has also been used in combination with other drugs, such as LD Ara-C and etoposide, giving CR rates between 40% and 60%. [13][14][15] However, those schedules of oral ZVD are both associated with hematological and extrahematological toxicity that hinders their use in poor risk elderly patients with AML.…”

Section: Introductionmentioning

confidence: 99%

True

1999

Leukemia

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We have conducted a phase II outpatient trial testing weekly oral administration of idarubicin (ZAVEDOS-ZVD) alone to determine the rate of objective response and toxicity in poor risk acute myeloid leukemia (AML) patients over 60 years of age. The treatment consisted of three phases: induction, with 20 mg/m 2 of ZVD on days 1, 8, 15 and 22; consolidation with 20 mg/m 2 of ZVD for 4 weeks; and maintenance with six cycles lasting 3 months and consisting of oral 6 mercapto-purine 2 mg/kg/day, 4 days a week for 2 months; subcutaneous cytarabine 1 mg/kg, once a week for 2 months; and oral ZVD 20 mg/m 2 on day 1 and day 8 of the third month. In case of failure after induction course, patients received salvage treatment with 4 weekly oral doses of 40 mg/m 2 ZVD. Fifty-one patients with a median age of 76 years were enrolled and could receive induction course. Of these 51 patients, 37 could receive subsequent courses, which consisted either of consolidation, or salvage. Only 11 patients underwent maintenance treatment. Sixty-three percent of patients had to be hospitalized during induction, for a median duration of 14.5 days, and 87% required hospitalization during salvage for a median duration of 17.5 days. Only five patients (38%) required hospitalization during consolidation. There were three toxic deaths (6%), two from hemorrhage and one from pulmonary embolism. The overall response rate was 29%, with 12 patients in complete response (25%) and two in partial response (4%). The median overall survival rate is 4 months for the whole population, and the median DFS is 9.6 months among the 14 responding patients. The results of this trial show that this new weekly schedule of oral ZVD chemotherapy is feasible and effective in poor risk elderly patients with AML. This regimen may be helpful for patients unable to tolerate intensive intravenous regimens, and is a real alternative to palliative treatments.

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