Behenoyl cytosine arabinoside, daunorubicin, 6-mercaptopurine, and prednisolone combination therapy for acute myelogenous leukemia in adults and prognostic factors related to remission duration and survival length.

Abstract

Fifty-one consecutive previously untreated adult patients with acute myelogenous leukemia (AML) were treated with BHAC-DMP (N4-behenoyl-I-beta-D-arabinofuranosyl-cytosine, daunorubicin, 6-mercaptopurine, and prednisolone) therapy. Forty-two patients (82.4%) achieved complete remission (CR). The Kaplan-Meier analysis revealed a probability for remaining in remission of 14% and for survival of 23% at 6 years. Pretreatment factors related to the achievement of CR, such as age, French-American-British (FAB) classification and WBC at the start of treatment, were not identified. Factors related to the CR duration and survival time of the patients who had achieved CR were first analyzed by a univariate analysis with the generalized Wilcoxon test. WBC count at the start of treatment, percent of blasts in the marrow at 1 and 2 weeks after the initiation of therapy, days required until CR, number of courses of induction therapy required until CR, and days required for the disappearance of circulating blasts were identified as statistically significant prognostic factors. When these characteristics were further analyzed by the Cox multivariate regression model, the percent of blasts in the bone marrow at 2 weeks was the most important prognostic factor with a statistical significance, and WBC count at the start of treatment and days required until CR (or number of courses required to achieve CR) were also important factors, with borderline significance.

Reconstitution of peripheral blood lymphocyte subsets in the long-term disease-free survivors of patients with acute myeloblastic leukemia

“…In the JALSG protocol, it takes approximately 2 years to complete the chemotherapy from the remission induction through the consolidation and maintenance therapy. 1 In the protocol for AML in JALSG, the duration of therapy is very long and cyclophosphamide and prednisolone are used in the maintenance therapy. These drugs may influence the lymphocytes subsets especially at the early period after chemotherapy.…”

“…1,2 With the use of techniques such as polymerase chain reaction (PCR), minimal residual disease (MRD) can be detected at an early stage after chemotherapy in the patients who are in complete remission (CR). Some investigators show that the elimination of MRD detected by PCR is not always necessary for long-term survival, 3 however, it has been also shown that patients with a higher level of MRD appeared to have an increased chance of relapse and that MRD disappears in conjunction with the duration of CR in some patients with acute leukemia.…”

Importance of c-kit mutation detection method sensitivity in prognostic analyses of t(8;21)(q22;q22) acute myeloid leukemia

“…BHAC-DM-based regimen was a response-oriented individualized chemotherapy regimen using BHAC, dounorbicin (DNR) and 6-mercaptppurine (6-MP). [35][36][37][38] All patients obtained complete remission by induction therapies. For post-remission consolidation, BHAC-based and HDACbased regimens were administered in 14 and 12 cases, respectively.…”

In vitro Sensitivity of Various Human Tumors to, l-Beta-D-Arabinofuranosylcytosine and, N⁴-Behenoyl-l-Beta-D-Arabinofuranosylcytosine

“…Kimura et al [9] reported that 35% of leukemic patients treated achieved com plete remission, in the phase II study of BH-AC. Moreover, BH-AC combined with daunomycin, 6-mercaptopurine or vincristine is effective for treating human leukemia [10,11]. Patients with gastroin testinal or breast cancer respond better to treatment with a combination of mitomy cin C (MMC), 5-fluorouracil (5-FU) and BH-AC, than to MMC and 5-FU alone [12], hence, BH-AC is effective for treating solid tumors, under conditions of com bined chemotherapy.…”