International Journal of Hematology

, Volume 87, Issue 2, pp 118–125

The value of oral cytarabine ocfosfate and etoposide in the treatment of refractory and elderly AML patients

  • Akira Horikoshi
  • Kazuhiro Takei
  • Yoshifumi Hosokawa
  • Shigemasa Sawada
Original Article


Twenty-one acute myeloid leukemia (AML) patients were enrolled and received oral induction therapy with cytarabine ocfosfate (SPAC) and etoposide (EP). The median age was 69 years (range: 33–86). There were 11 patients with de novo AML and 10 AML cases that had evolved from myelodysplastic syndromes. Seventeen patients had abnormal karyotypes including eight complex abnormalities, various complications, and 7 of 21 had a poor performance status (PS) with Eastern Cooperative Oncology Group (ECOG) scores of 3–4. All patients completed induction therapy without severe adverse events. Seven achieved complete remission (CR), and two achieved partial remission (PR). Uni- and multivariate analyses demonstrated a positive and significant correlation between the results of therapy (CR ± PR) and overall survival. The plasma concentrations of cytosine arabinoside (ara-C) in some cases were higher than those previously reported, indicating the accumulation of ara-C with increasing numbers of days of SPAC administration. We conclude that this therapy is well tolerated and useful for refractory and elderly AML patients.


Cytarabine ocfosfate Ara-C Etoposide Refractory acute myeloid leukemia Induction therapy 


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Copyright information

© The Japanese Society of Hematology 2008

Authors and Affiliations

  • Akira Horikoshi
    • 1
  • Kazuhiro Takei
    • 1
  • Yoshifumi Hosokawa
    • 1
  • Shigemasa Sawada
    • 1
  1. 1.Department of Internal MedicineNihon University, Nerima-Hikarigaoka HospitalNerima-ku, TokyoJapan

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