Combination of rubidazone and cytosine arabinoside in the treatment of first relapse in acute myelocytic leukemia

Abstract

This study tested the efficacy of rubidazone and cytosine arabinoside in 35 patients (13 children and 22 adults) with acute myelocytic leukemia in first relapse. Induction consisted of 1-2 courses of rubidazone 200 mg/m2 days x 4 days plus cytosine arabinoside 100 mg/m2 x 7 days in CI followed by 2 consolidation courses of 3 days and 5 days. Nineteen patients (54%) achieved complete remission, 8 failed to respond, and 8 died. Twelve patients relapsed after 1 to 9 months, at a median of 4 months, 1 patient died of cardiac failure and 1 remains in complete remission at 12 months. Five patients underwent bone marrow transplantation, 3 of them autologous, 1 was still in complete remission at 29 months, 1 relapsed, and 1 died of sepsis. Two received allogeneic marrow transplants and died at 3 and 4 months afterwards of VOD and graft failure. The main toxicity was severe and prolonged myelosuppression.

Antibody-targeted chemotherapy of older patients with acute myeloid leukemia in first relapse using Mylotarg (gemtuzumab ozogamicin)

“…Moreover, the incidence of grade 3 or 4 infections has been reported to be as high as 83% for adults with relapsed or refractory AML treated with conventional combination therapy. 44 Patients treated with Mylotarg may have a relatively low incidence of severe infections because the targeted nature of the therapy may cause only limited damage to the gastrointestinal mucosa so that these myelosuppressed patients have a lower incidence of bacteremia. This low incidence of severe infection may have contributed to the low early death rate of the older Mylotargtreated patients because infection is a major cause of early deaths in AML patients.…”