Therapeutic effects of a combination of intermediate-dose cytosine arabinoside, adriamycin and vincristine in relapsed acute leukemia]

Eleven cases of acute leukemia, 8 relapsed and 3 refractory to a conventional induction chemotherapy, were treated with a combination of intermediate-dose cytosine arabinoside (ara-C), adriamycin (ADM) and vincristine (VCR). They consisted of 9 ANLL and 2 ALL. The therapeutic regimen consisted of 1-hour infusion of ara-C of a dose of 500 mg/m2 every 12 hours for 6 days from days 3 to 8, ADM, 40 mg/m2, on day 1 and VCR, 1.4 mg/m2, on day 2. Among 11 cases in which an evaluation was possible, 7 obtained complete remission (CR). The CR rate was 77.8% in the 9 cases of ANLL. The toxicity of this regimen included the following: conjunctivitis in 4 of 11 cases (36%), nausea and vomiting in 9 of 11 cases (91%) and hair loss in all cases, although no toxicities of the central nervous system of liver were observed. The mean level of serum concentration of ara-C was above 10 microM at 15, 30 and 60 minutes after the initiation of infusion. The therapeutic effect of this regimen consisting of intermediate-dose ara-C is expected to be useful not only in induction of refractory and relapsed acute leukemia, but also in the postremission therapy of CR cases.