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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 |
| Affiliation: | 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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