Bogdan Popescu, Sheenu Sheela, Julie Thompson, Sophia Grasmeder, Therese Intrater, Christin B DeStefano, Christopher S Hourigan, Catherine Lai
{"title":"针对复发或难治性急性髓性白血病的定时序贯挽救性化疗。","authors":"Bogdan Popescu, Sheenu Sheela, Julie Thompson, Sophia Grasmeder, Therese Intrater, Christin B DeStefano, Christopher S Hourigan, Catherine Lai","doi":"10.2991/chi.d.191128.001","DOIUrl":null,"url":null,"abstract":"<p><p>Therapy for those with relapsed or refractory acute myeloid leukemia is suboptimal. Studies have suggested that timed sequential salvage combination cytotoxic chemotherapy may have particular utility for that indication. We report here a series of ten such adult patients treated sequentially at a single center with EMA (cytarabine 500 mg/m<sup>2</sup>/day as continuous infusion on days 1-3 and days 8-10, mitoxantrone 12 mg/m<sup>2</sup>/day on days 1-3, and etoposide 200 mg/m<sup>2</sup>/day as continuous infusion on days 8-10). The overall complete remission rate was 40% (including 3 of 4 of those with relapsed disease) but use of this regimen was associated with prolonged cytopenia and a high rate of infectious adverse events. Even with the availability of modern infectious prophylaxis and therapies, the EMA regimen is likely best reserved for those with relapsed disease treated with curative intent prior to an allogeneic hematopoietic cell transplant.</p>","PeriodicalId":10368,"journal":{"name":"Clinical Hematology International","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/8a/CHI-2-1-27.PMC7079712.pdf","citationCount":"0","resultStr":"{\"title\":\"Timed sequential salvage chemotherapy for relapsed or refractory acute myeloid leukemia.\",\"authors\":\"Bogdan Popescu, Sheenu Sheela, Julie Thompson, Sophia Grasmeder, Therese Intrater, Christin B DeStefano, Christopher S Hourigan, Catherine Lai\",\"doi\":\"10.2991/chi.d.191128.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Therapy for those with relapsed or refractory acute myeloid leukemia is suboptimal. Studies have suggested that timed sequential salvage combination cytotoxic chemotherapy may have particular utility for that indication. We report here a series of ten such adult patients treated sequentially at a single center with EMA (cytarabine 500 mg/m<sup>2</sup>/day as continuous infusion on days 1-3 and days 8-10, mitoxantrone 12 mg/m<sup>2</sup>/day on days 1-3, and etoposide 200 mg/m<sup>2</sup>/day as continuous infusion on days 8-10). The overall complete remission rate was 40% (including 3 of 4 of those with relapsed disease) but use of this regimen was associated with prolonged cytopenia and a high rate of infectious adverse events. Even with the availability of modern infectious prophylaxis and therapies, the EMA regimen is likely best reserved for those with relapsed disease treated with curative intent prior to an allogeneic hematopoietic cell transplant.</p>\",\"PeriodicalId\":10368,\"journal\":{\"name\":\"Clinical Hematology International\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/8a/CHI-2-1-27.PMC7079712.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Hematology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2991/chi.d.191128.001\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/12/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Hematology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2991/chi.d.191128.001","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/12/9 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Timed sequential salvage chemotherapy for relapsed or refractory acute myeloid leukemia.
Therapy for those with relapsed or refractory acute myeloid leukemia is suboptimal. Studies have suggested that timed sequential salvage combination cytotoxic chemotherapy may have particular utility for that indication. We report here a series of ten such adult patients treated sequentially at a single center with EMA (cytarabine 500 mg/m2/day as continuous infusion on days 1-3 and days 8-10, mitoxantrone 12 mg/m2/day on days 1-3, and etoposide 200 mg/m2/day as continuous infusion on days 8-10). The overall complete remission rate was 40% (including 3 of 4 of those with relapsed disease) but use of this regimen was associated with prolonged cytopenia and a high rate of infectious adverse events. Even with the availability of modern infectious prophylaxis and therapies, the EMA regimen is likely best reserved for those with relapsed disease treated with curative intent prior to an allogeneic hematopoietic cell transplant.