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High-dose cytosine arabinoside intensification for acute nonlymphocytic leukemia in patients over 56 years of age.

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Ferrant, Augustin [UCL] Doyen, Chantal Delannoy, André [UCL] Van den Bossche, L Martiat, P. Deneys, Véronique [UCL] De Bruyère, Marc [UCL] Bosly, André [UCL] Michaux, Jean-Louis [UCL] Sokal, G.

One hundred and nine consecutive patients with de novo acute nonlymphocytic leukemia aged over 56 years were admitted with the intention of administering high-dose cytosine arabinoside (HD Ara-C) intensification. After remission induction, the patients were consolidated with a course of daunorubicin (30 mg/m2/day, days 1-3) and Ara-C (100 mg/m2/day, days 1-7), followed by the intensification (Ara-C, 2 g/m2/12 h, days 1-4). The planned induction course was not started in 13 patients because of cardiac failure or unsatisfactory general status. Remission was achieved in 55% (53/96) of the patients. Twenty-seven patients (28%) had refractory disease, seven died early during induction therapy, five died of hemorrhage and three of infection during the hypoplasia that followed induction treatment. Thirty-nine patients started consolidation and 32 had the planned intensification. In these last patients the 3-year leukemia-free survival (LFS) probability was 29% (SE, 8%). No patient died as a consequence of intensification. The relapse rate of the intensified patients did not differ from the relapse rate of those patients who did not receive the planned intensification (p = 0.12). The only pretreatment variables significantly associated with a better LFS were younger age (p = 0.02) and a low WBC at diagnosis (p = 0.04). For the whole patient group, the 3-year survival probability was 15% (SE, 4%). This study shows that elderly patients can tolerate HD Ara-C. The patients completing consolidation-intensification have a currently acceptable LFS. To what extent HD Ara-C contributed to the length of the remissions remains unclear.

Document type Article de périodique (Journal article) – Journal Article
Access type Accès restreint
Publication date 1992
Journal information "Annals of hematology" - Vol. 64, no. 4, p. 185-9 (1992)
Peer reviewed yes
issn 0939-5555
Affiliation UCL - MD/MINT - Département de médecine interne
MESH Subject Aged ; Aged, 80 and over ; Cytarabine - administration & dosage - toxicity ; Dose-Response Relationship, Drug ; Drug Tolerance ; Female ; Humans ; Leukemia, Myeloid, Acute - drug therapy ; Male ; Middle Aged ; Remission Induction ; Thrombocytopenia - chemically induced
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Bibliographic reference Ferrant, Augustin ; Doyen, Chantal ; Delannoy, André ; Van den Bossche, L ; Martiat, P. ; et. al. High-dose cytosine arabinoside intensification for acute nonlymphocytic leukemia in patients over 56 years of age.. In: Annals of hematology, Vol. 64, no. 4, p. 185-9 (1992)
Permanent URL http://hdl.handle.net/2078.1/13654