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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) |
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| Authors: | A 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 |
| Institution: | Medizinische Klinik III, Klinikum der Universit?t Frankfurt, Germany, DE Medizinische Klinik III, Klinikum der Universitat Ulm, Germany, DE II. Medizinische Klinik, St?dtisches Klinikum Karlsruhe, Germany, DE Abteilung für H?matologie-Onkologie, Ev. Krankenhaus Essen-Werden, Germany, DE 2. Medizinische Klinik, Klinikum Nürnberg, Germany, DE Abteilung für H?matologie, III. Medizinische Klinik der Universit?t Mainz,Germany, DE Medizinische Klinik II, Klinikum der RWTH Aachen, Germany, DE Abteilung für H?matologie-Onkologie, München-Harlaching, Germany, DE Medizinische Klinik B, Klinikum Wiesbaden, Germany, DE Medizinische Klinik, Krankenhaus Nordwest, Frankfurt, Germany, DE Klinik für Innere Medizin II, Klinikum der Universit?t Jena, Germany, DE |
| 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. Received: March 23, 1999 / Accepted: June 23, 1999 |
| Keywords: | Acute myeloid leukemia Myelodysplastic syndrome Secondary leukemia Interleukin-2 G-CSF |
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