High-Dose Cytosine Arabinoside Therapy in Refractory Acute Leukemia

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  • 急性白血病再発例に対するCytosine Arabinoside (ara-C)大量療法
  • キュウセイ ハッケツビョウ サイハツレイ ニ タイスル Cytosine Ar

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Abstract

Clinical effects of high dose cytosine arabinoside (H-D ara-C) therapy were studied in 4 cases of refractory acute leukemia. They were one acute myelocytic leukemia (AML: M1), one acute promyelocytic leukemia (APL: M3) and two acute lymphocytic leukemia (ALL: L2). The ratio of male to female was 3: 1 and age ranged from 26 y/o to 73 y/o with a median of 50 y/o. All patients except one ALL were previously treated with the conventional dose of ara-C in combination of anthracyclines and others. In a case of AML, H-D ara-C therapy was done at the time of the 1st and the 2nd relapse. Ara-C, 2.5 g∼2.8 g/m2, was administrated by intravenous drip infusion twice a day for 2∼5 days. The complete remission (CR) was obtained in 3 of 4 evaluable cases (75%). The days required to achieve CR ranged from 28 days to 63 days with a median of 47 days and the duration of CR ranged from 1.0 month to 3.5 months with a median of 1.5 months. The major side effects were myelosuppression and central nervous system (CNS) toxicity. Myelosuppression was severe and all patients were suffered from infections. CNS toxicities were observed in 2 cases. A case of AML, showing somnolence and urinary incontinence, completely recovered from these symptoms, however, another case of ALL died of pneumonia before the recovery from coma.<br>H-D ara-C therapy will be expected in the clinical management of refractory acute leukemia.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 25 (12), 1941-1946, 1984

    The Japanese Society of Hematology

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