Original Manuscript
Leukemia (2005) 19, 978–983. doi:10.1038/sj.leu.2403766 Published online 21 April 2005
Acute Promyelocytic Leukemia
High-dose cytarabine and mitoxantrone in consolidation therapy for acute promyelocytic leukemia
R F Schlenk1, U Germing2, F Hartmann3, A Glasmacher4, J T Fischer5, F del Valle y Fuentes6, K Götze7, H Pralle8, C Nerl9, H Salwender10, W Grimminger11, A Petzer12, M Hensel13, A Benner14, L Zick1, K Döhner1, S Fröhling1 and H Döhner1 for the AML Study Group (AMLSG)
- 1Department of Internal Medicine III, University Hospital of Ulm, Germany
- 2Department of Hematology, Oncology and Clinical Immunology, University of Düsseldorf, Germany
- 3Department of Internal Medicine I, University of Homburg, Germany
- 4Department of Internal Medicine I, University of Bonn, Germany
- 5Städtisches Klinikum, Karlsruhe, Germany
- 6Städtisches Klinikum, Oldenburg, Germany
- 7Department of Internal Medicine III, Technical University of Munich, Germany
- 8Department of Internal Medicine IV, University of Giessen, Germany
- 9Städtisches Krankenhaus München-Schwabing, Munich, Germany
- 10Allgemeines Krankenhaus Altona, Hamburg, Germany
- 11Klinikum, Stuttgart, Germany
- 12Department of Internal Medicine, University of Innsbruck, Austria
- 13Department of Internal Medicine V, University of Heidelberg, Germany
- 14Central Unit of Biostatistics, German Cancer Research Center Heidelberg, Germany
Correspondence: Dr RF Schlenk, Department of Internal Medicine III, University Hospital of Ulm, Robert-Koch-Strasse 8, 89081 Ulm, Germany. Fax: +49 731 50024405; E-mail: richard.schlenk@medizin.uni-ulm.de
Received 24 September 2004; Accepted 21 February 2005; Published online 21 April 2005.
Abstract
The objective of our study was to evaluate high-dose cytarabine in consolidation therapy in patients with newly diagnosed acute promyelocytic leukemia (APL). Patients (age 16–60 years) received induction therapy according to the AIDA protocol (all-trans retinoic acid, idarubicin) followed by one cycle of ICE (idarubicin, cytarabine, etoposide) and two cycles of HAM (cytarabine 3 g/m2 q12h, days 1–3; mitoxantrone 10 mg/m2, days 2 and 3). From 1995 to 2003, 82 patients were enrolled. In total, 72 patients (88%) achieved a complete remission, and 10 patients (12%) died from early/hypoplastic death (ED/HD). A total of 71 patients received at least one cycle of HAM. Relapse-free survival (RFS) and overall survival (OS) after 46 months were 83 and 82%, respectively. White blood cell count above 10.0 
109/l at diagnosis and additional chromosomal aberrations were unfavorable prognostic markers for OS, whereas no prognostic markers for RFS were identified including FLT3 mutations. In conclusion, high-dose cytarabine in consolidation therapy for patients with newly diagnosed APL is an effective treatment approach.
Keywords:
acute promyelocytic leukemia, high-dose cytarabine, activating FLT3 mutations, additional chromosomal aberrations
