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Carboplatin-Based High-Dose Therapy for Refractory Acute Myeloid Leukaemia

  • R. Bassan
  • T. Lerede
  • M. Buelli
  • A. Rossi
  • A. Rambaldi
  • G. Borleri
  • P. Bellavita
  • B. Comotti
  • S. Cortelazzo
  • P. Viero
  • T. Barbui
Part of the Haematology and Blood Transfusion / Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 39)

Abstract

A combination of carboplatin plus high-dose ara-C and either mitoxantrone or idarubicin (crossover) was used in 26 adults with refractory or relapsed AML and the following high-risk features: primary refractory 38%, > 2nd relapse 23%, 1st CR < 12 mos. 11%, age > 60 years 19%, FAB M5/secondary AML 23%, prior high-dose ara-C 35%, prior bone marrow transplant 27%. The first regimen (12 patients) with carboplatin 300 mg/m2/d (24-hour infusion) on days 1–4, high-dose ara-C 1 g/m2/bd on days 1–5, mitoxantrone (idarubicin) 12 (6) mg/m2/d on days 1–3 was highly toxic resulting in the early death of 7 patients. With a reduced intensity regimen (14 patients) consisting of carboplatin as above, high-dose ara-C on alternate days (1, 3, 5), and mitoxantrone (idarubicin) reduced to 8 (5) mg/m2/dose, the response rate was 64% (7 complete and 2 partial remissions). Complete remissions were consolidated with lower-intensity chemotherapy and autologous (n = 5) or allogeneic (n = 2) bone marrow/peripheral blood cell transplants. Overall survival was 2.1 months, responders living longer (median 11 months, 2-year probability 0.34) than nonresponders (p < 0.001). The second carboplatin-based regimen was effective in the management of patients with advanced-stage AML and ≤2 high-risk features. Mobilization of CD34+ circulating blood cells for autografting was possible and a prolonged remission was obtained in some of these patients.

Keywords

Acute Myeloid Leukemia Complete Remission Complete Remission Rate Acute Nonlymphocytic Leukemia Refractory Acute Myeloid Leukemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • R. Bassan
    • 1
  • T. Lerede
    • 1
  • M. Buelli
    • 1
  • A. Rossi
    • 1
  • A. Rambaldi
    • 1
  • G. Borleri
    • 1
  • P. Bellavita
    • 2
  • B. Comotti
    • 1
  • S. Cortelazzo
    • 1
  • P. Viero
    • 1
  • T. Barbui
    • 1
  1. 1.Division of HaematologyOspedali RiunitiBergamoItaly
  2. 2.Division of Immunohaematology & Transfusion ServiceOspedali RiunitiBergamoItaly

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