Abstract |
Topotecan and retinoids are among the most promising agents being evaluated for the treatment of acute myelogenous leukemia (AML), refractory anemia with excess blasts ( RAEB), and refractory anemia with excess blasts in transformation ( RAEB-t). Single-agent topotecan is similar to single-agent ara-C, but may be superior in patients with poor-prognosis chromosome abnormalities (ie, -5,-7). Topotecan plus ara-C is equivalent to topotecan alone in chronic myelomonocytic leukemia (CMML), but significantly more effective in RAEB and RAEB-t. Compared with single-agent ara-C, the complete remission (CR) rate with topotecan plus ara-C is comparable, although it offers special advantages in patients with the -5,-7 karyotype. In patients with poor-prognosis cytogenetics, the combination of cyclophosphamide, ara-C, and topotecan, plus all-trans retinoic acid (ATRA) and granulocyte colony-stimulating factor ( G-CSF) appears favorable. In a recent study of triple-agent chemotherapy using fludarabine, ara-C, and idarubicin, with or without ATRA and G-CSF, median survival among poor-prognosis patients was 6-7 months, but those who received ATRA did better than those who did not, primarily because it improved survival in those who did not achieve CR. G-CSF produced higher CR rates but had no effect on survival or disease-free survival.
|
Authors | E H Estey |
Journal | Leukemia
(Leukemia)
Vol. 12 Suppl 1
Pg. S13-5
(Sep 1998)
ISSN: 0887-6924 [Print] England |
PMID | 9777888
(Publication Type: Journal Article, Review)
|
Chemical References |
- Antineoplastic Agents
- Retinoids
- Topotecan
|
Topics |
- Anemia, Refractory, with Excess of Blasts
(drug therapy)
- Antineoplastic Agents
(therapeutic use)
- Humans
- Leukemia, Myeloid, Acute
(drug therapy)
- Retinoids
(therapeutic use)
- Topotecan
(therapeutic use)
|