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Intensive chemotherapy with idarubicin, ara-C, etoposide, and m-AMSA followed by immunotherapy with interleukin-2 for myelodysplastic syndromes and high-risk Acute Myeloid Leukemia (AML).

Abstract
Intensive chemotherapy followed by treatment with interleukin-2 (IL-2) was evaluated in a prospective, randomized, multicenter trial including 18 patients with refractory anemia with excess of blasts in transformation (RAEB-T), 86 patients with acute myeloid leukemia (AML) evolving from myelodysplastic syndromes, and six patients with secondary AML after previous chemotherapy. Median age was 58 years (range: 18-76 years). Forty-nine patients (45%) achieved a complete remission (CR) after two induction cycles with idarubicin, ara-C, and etoposide, 52% of them aged </=60 years and 35% aged >60 years (p=0.06). After two consolidation courses, patients were randomized to four cycles of either high- or low-dose IL-2. Patients aged up to 55 years with an HLA-identical sibling donor were eligible for allogeneic bone marrow transplantation. The median relapse-free survival was 12.5 months, with a probability of ongoing CR at 6.5 years of 19%. Overall survival of all patients was 8 months, and 21 months for the CR patients. Median survival was significantly longer among patients aged </=60 years than among the older patients (16 vs 6 months, p<0.001). Median duration of survival and relapse-free survival were not statistically different in the two IL-2 treatment arms.
AuthorsA Ganser, G Heil, G Seipelt, W Hofmann, J T Fischer, W Langer, W Brockhaus, K Kolbe, T H Ittel, N Brack, H G Fuhr, P Knuth, K Höffken, L Bergmann, D Hoelzer
JournalAnnals of hematology (Ann Hematol) Vol. 79 Issue 1 Pg. 30-5 (Jan 2000) ISSN: 0939-5555 [Print] Germany
PMID10663618 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Interleukin-2
  • Cytarabine
  • Etoposide
  • Idarubicin
Topics
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Cytarabine (administration & dosage)
  • Dose-Response Relationship, Drug
  • Etoposide (administration & dosage)
  • Female
  • Humans
  • Idarubicin (administration & dosage)
  • Immunotherapy
  • Interleukin-2 (therapeutic use)
  • Leukemia, Myeloid (drug therapy)
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes (drug therapy, therapy)
  • Prospective Studies
  • Survival Rate

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