EFFECTIVE REMISSION INDUCTION OF REFRACTORY CHILDHOOD ACUTE NONLYMPHOCYTIC LEUKEMIA BY VP-16-213 PLUS AZACITIDINE

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 65  (11-1) , 995-999
Abstract
Children and young adults (38) with advanced acute nonlymphocytic leukemia (ANLL) in relapse were treated with VP-16-213 plus azacytidine (5AZ). Each patient had previously received many chemotherapeutic drugs, including anthracyclines and cytarabine. Initially, 16 patients received a 5-day course of VP-16-213 (100 mg/m2) daily .times. 3 days and 5AZ (150 mg/m2) daily .times. 2 days, repeated after 9-16 days. Since this treatment produced marrow hypoplasia and complete remission (CR) in only 1 of 16 patients, a more intensive regimen was devised. The remaining 22 patients received a course of VP-16-213 (200 mg/m2) daily .times. 3 days, followed by 5AZ (300 mg/m2) daily .times. 2 days, repeated after 1-2 days until the bone marrow became hypoplastic. After 2-4 courses, 18 patients had marrow hypoplasia; 10 of these achieved CR. The proportion of patients achieving CR with the higher doses was significantly greater than that with the initial doses (P .ltoreq. 0.05). The toxicity also increased with the higher doses, with major problems due to prolonged pancytopenia. Supportive therapy was required for severe bleeding and infections. The intensive treatment with VP-16-213 plus 5AZ evidently can effectively induce remission in patients with refractory advanced acute nonlymphocytic leukemia.