Treatment of Early Acute Nonlymphatic Leukemia with Low Dose Cytosine Arabinoside

Moloney, W. C.; Rosenthal, D. S.

doi:10.1007/978-3-642-67984-1_8

Cited by 37 publications

(10 citation statements)

References 4 publications

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“…The reported clinical data suggests that both the patient population as well as the dose and route of administration of ARA-C were similar in both studies. Our response rate is comparable to a previous series that reported two CR in nine AML patients treated with low-dose ARA-C (Moloney & Rosenthal, 1981).…”

Section: Discussionsupporting

confidence: 88%

Low‐dose ARA‐C fails to enhance differentiation of leukaemic cells

1985

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Nine patients with acute myelogenous leukaemia were treated with low-dose ARA-C (10 mg/m2, q 12h) for a planned 21 d. Complete remission was attained in only one patient (11.1%). Definite cytoreductive effect was seen in four additional patients. There was one treatment-related death. Haematologic toxicity occurred in all nine patients with sever thrombocytopenia most prominent. Severe hepatotoxicity precluded further ARA-C treatment in one patient. Because of toxicity only two patients were able to complete their scheduled 3 week courses of low-dose ARA-C. No evidence of ARA-C induced differentiation of leukaemic cells was noted on follow-up bone marrow examination during or shortly after the treatment course. The utility and indication for low-dose ARA-C therapy of AML remains to be determined.

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Section: Discussionsupporting

confidence: 88%

Low‐dose ARA‐C fails to enhance differentiation of leukaemic cells

1985

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“…In the case reported by Baccarini & Tura (1 9 79) a relapse was again sensitive to small doses of ARA-C, thus confirming the effectiveness of this treatment. Recently, two out of nine patients with early acute non-lymphocytic leukaemia were also successfully treated with low dose ARA-C (Maloney & Rosenthal, 1981).…”

Section: Discussionmentioning

confidence: 99%

Small doses of ARA‐C in the treatment of acute myeloid leukaemia: differentiation of myeloid leukaemia cells?

1982

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Three patients with acute myeloid leukaemia were treated with small doses of ARA-C (10 mg/m2/12 h, subcutaneous injections) and complete remission was obtained. The small doses of ARA-C, the progressive evolution, the absence of aplasia before remission, the simultaneous presence of normal islets of promyelocytes and leukaemic myeloblasts, favour a differentiating role for the drug rather than an antimitotic effect.

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“…[4][5][6][7][8][9][10][11] It is well tolerated and can be given in the outpatient or home care setting. Its mechanism of action at low doses is not completely clear: Some believe that it retains cytotoxic action, and some have view that it induces apoptosis by differentiation induction.…”

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confidence: 99%

A comparison of low‐dose cytarabine and hydroxyurea with or without all‐trans retinoic acid for acute myeloid leukemia and high‐risk myelodysplastic syndrome in patients not considered fit for intensive treatment

Burnett

Milligan

Prentice

et al. 2007

Cancer

563

465

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BACKGROUNDThe survival of older patients with acute myeloid leukemia has not improved. Few clinical trials have been available for older patients who are not considered fit for an intensive chemotherapy approach.METHODSBetween December 1998 and November 2003, as part of National Cancer Research Institute Acute Myeloid Leukemia 14 Trial, 217 patients, who were deemed unfit for intensive chemotherapy were randomized to receive low‐dose cytarabine (Ara‐C) (20 mg twice daily for 10 days) or hydroxyurea with or without all‐trans retinoic acid (ATRA).RESULTSLow‐dose ara‐C produced a better remission rate (18% vs 1%; odds ratio [OR], 0.15; 95% confidence interval [95% CI], 0.06–0.37; P = .00006) and better overall survival (OR, 0.60; 95% CI, 0.44–0.81; P = .0009), which was accounted for by the achievement of complete remission (CR) (duration of CR: 80 weeks vs 10 weeks for patients with no CR). Patients who had adverse cytogenetics did not benefit. ATRA had no effect. Toxicity scores or supportive care requirements did not differ between the treatment arms.CONCLUSIONSOlder, less fit patients have a poor outcome, and few trials have been conducted in this patient group. Low‐dose ara‐C treatment was superior to best supportive care and hydroxyurea because it had greater success in achieving CR, and it could represent standard care against which new treatments may be compared in this patient group. [See editorial on pages 000–000, this issue.] Cancer 2007 © 2007 American Cancer Society.

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Treatment of Early Acute Nonlymphatic Leukemia with Low Dose Cytosine Arabinoside

Cited by 37 publications

References 4 publications

Low‐dose ARA‐C fails to enhance differentiation of leukaemic cells

Low‐dose ARA‐C fails to enhance differentiation of leukaemic cells

Small doses of ARA‐C in the treatment of acute myeloid leukaemia: differentiation of myeloid leukaemia cells?

A comparison of low‐dose cytarabine and hydroxyurea with or without all‐trans retinoic acid for acute myeloid leukemia and high‐risk myelodysplastic syndrome in patients not considered fit for intensive treatment

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