Cancer Chemotherapy and Pharmacology

, Volume 28, Issue 6, pp 487–490 | Cite as

High-dose ara-C and etoposide in refractory or relapsing acute leukemia

  • Mathias Freund
  • Hartmut Link
  • Helmut Diedrich
  • Sebastian LeBlanc
  • Hans-Jochen Wilke
  • Hubert Poliwoda
Short Communication Ara-C, Etoposide, Leukemia


A total of 32 patients (15 men and 17 women) presenting with relapsing or refractory acute leukemia were treated with a 3-h infusion of 3 g/m2 cytosine arabinoside (ara-C) twice daily on days 1–6 and a 1-h infusion of 100 mg/m2 etoposide on days 1–5. In all, 6 subjects had acute lymphocytic leukemia (ALL); 25 had acute myeloid leukemia (AML) of types M1 (n=6), M2 (n=10), M4 (n=5), and M5 (n=4); and 1 had mixed-type leukemia. The median age was 35 years (ranges, 16–62 years). Of the patients presenting with AML, 11 were primarily refractory and 3 became refractory after their first relapse. Six subjects had an early first relapse following a complete remission (CR) that lasted <6 months and five, a second relapse. Another patient underwent a primary relapse after >6 months but had been heavily pretreated. In all, 5 subjects with refractory AML achieved a CR [36%; 95% confidence interval (CI), 10%–62%) as did 7 patients exhibiting relapsing AML (58%; CI, 30%–86%). Three patients who had relapsing or resistant ALL achieved a CR. Side effects consisted of severe hematotoxicity associated with granulocytopenia of <500/mm3 that lasted for a mean of 23.6 days and thrombocytopenia of <20,000/mm3 whose mean duration was 20.8 days. Marked gastrointestinal toxicity and infections were also prevalent. Cutaneous and ocular toxicity as well as allergic, pulmonary and cerebellar side effects were observed in a few cases. We conclude that the combination of high-dose ara-C and etoposide is a powerful but toxic induction regimen for refractory or relapsed acute leukemia.


Leukemia Acute Myeloid Leukemia Complete Remission Acute Lymphocytic Leukemia Etoposide 
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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • Mathias Freund
    • 1
  • Hartmut Link
    • 1
  • Helmut Diedrich
    • 1
  • Sebastian LeBlanc
    • 1
  • Hans-Jochen Wilke
    • 1
  • Hubert Poliwoda
    • 1
  1. 1.Department of Hematology and OncologyHannover Medical SchoolHannover 61FRG

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