Treatment of High-Risk Relapsing or Refractory AML with M-AMSA and ID-ARAC

Freund, Mathias; Giller, S. A.; Hinrichs, F.; Baars, Axel; Meran, Johannes G.; Körfer, Alfred; Poliwoda, H.

doi:10.1007/978-3-642-76591-9_76

Cited by 1 publication

(2 citation statements)

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“…Treatment of AML with m-AMSA as single-agent therapy has been reported to produce CR rates of 17-28 %, with a median duration of CR of 4 months when used either in previously untreated, relapsed, or refractory disease (5, 25). An improvement in both indices of response has been reported when m-AMSA was administered in conjunction with other agents, particularly cytarabine, and in some studies the response rate in previously untreated as well as treated patients has been equivalent to that of the 7-3 regimen (9-11, 22,26).…”

Section: Discussionmentioning

confidence: 91%

“…The regimen was designed to incorporate cytarabine with m-AMSA at a dosage schedule of cytarabine which avoided high dosages inappropriate for use in patients > 60 yr of age as described above. Clinical efficacy of cytarabine with minimal neurotoxicity in such patients can, however, be attained either by intermediate-dosage cytarabine schedules (22), or by the conventional-dosage schedule which was employed in the present study. Thioguanine was included as it represented an agent with potential additive chemotherapeutic activity in a regimen in which the target population included a significant proportion of patients who had not previously been exposed to this drug.…”

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confidence: 94%

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An effective age‐unrestricted m‐AMSA‐based second‐line regimen for poor prognosis acute myeloid leukaemia

Watson

Seymour

Lee

et al. 1994

European J of Haematology

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The efficacy and toxicity of a regimen consisting of amsacrine (m‐AMSA), cytarabine, and thioguanine for remission‐induction therapy in poor prognosis categories of acute myeloid leukaemia (AML) were determined in a single arm study of 46 patients. The study group consisted of 17 patients with disease refractory to daunorubicin plus cytarabine‐based induction regimens, 22 patients with disease which had relapsed during daunorubicin plus cytarabine maintenance therapy, or following completion of this maintenance programme after receiving > 500 mg daunorubicin/m2, and 7 previously untreated patients where cardiac disease contraindicated anthracycline therapy. Complete remission (CR) was attained in 46%, and probability of survival was comparable to published results for first‐line treatment with daunorubicin plus cytarabine regimens. There was no statistically significant difference in CR rate or probability of survival between these three categories of poor prognosis AML, and cardiotoxic complications were uncommon despite extensive anthracycline exposure in the majority. In the 43% of patients who were 60–76 years of age, there was no statistically significant difference in CR rate or probability of survival relative to patients <60 years. This observation fails to support the view that less myelotoxic regimens with lesser efficacy should be the basic approach to treatment of AML in patients > 60 years of age.

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Section: Discussionmentioning

confidence: 91%

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confidence: 94%