DCTP (II) combination chemotherapy of adult acute nonlymphocytic leukemia
Kobayashi, T.; Ogawa, M.; Kuraishi, Y.; Nagata, T.; Aiba, K.; Nakamura, T.; Usui, N.; Yamazaki, H.; Ichiba, K.; Isogai, Y.
Nihon Ketsueki Gakkai Zasshi Journal of Japan Haematological Society 51(5): 855-863
1988
ISSN/ISBN: 0001-5806 PMID: 3206983 Document Number: 315072
Fifty-one consecutive patients with acute nonlymphocytic leukemia (ANLL) were treated with DCTP (II) combination chemotherapy consisting of daunomycin (30 mg/m2 i.v.) on Days 1 and 2, cytosine arabinoside (Ara-C, 40 mg/ms) by drip infusion at 12-hour intervals for 7 days, 6-thioguanine (60 mg/m2/day) orally for 7 days and prednisolone (PDN, 60 mg/m2/day) orally for 5 days. When complete remission (CR) was obtained, 2 courses of the same combination were administered as consolidation. Maintenance and intensification therapy consisting of two different combinations (modified DCTP and OAP; vincristine, Ara-C, PDN) was given alternately every 4 weeks for 2 years. ANLL refractory to DCTP (II) therapy was treated with BH-AC.cntdot.AP regimen (N4-behenoyl-1-.beta.-D-arabinofuranosyl-cytosine, aclacinomycin-A, and PDN) as a second-line chemotherapy. The CR rate was 74% in 50 evaluable patients. The median duration of remission was 11.3 months with a median follow-up of 42 months and 29.7% of CR patients were estimated to remain in continuous remission at 6 years (Kaplan-Meier analysis). The median survival time was 39.3 months and actuarial 6-year survival was 21.8% in responders. Hematologic toxicity was a dose-limiting factor but this was clinically manageable. Other adverse effects such as hepatic dysfunction, nausea, vomiting, steroid diabetes, cardiotoxicity and peripheral neuropathy, were moderate or reversible.