Abstract
The combination of dcf and Ara-A was used in a terminally-ill patient with refractory T-ALL who suffered from persistent and recurrent malignant pleural and pericardial effusion and severe lower leg edema secondary to abdominal lymphadenopathy. After 1st course of dcf at 5 mg/m plus continuous infusion of Ara-A at 8 mg/kg/d × 5d, he went into complete hematological remission at 3 weeks, along with resolution of lower leg edema, pericardial effusion, and decreased rate of reaccumulation of pleural effusion. He received a 2nd course with 2 daily injections of dcf plus 3 daily infusions of Ara-A and remained in marrow remission. However, a bone marrow relapse occurred at week 7. He was given two more courses of 3 daily injections of dcf plus 5 daily infusions of Ara-A. Although there was total ablation of ADA activity in the mononuclear cells of both peripheral blood and bone marrow, remission was not achieved. The above treatment was well tolerated with the exception of transient episodes of drowsiness and hallucination which occurred in 3 of the 4 courses. Myelosuppression was mild and transient in all but the 1st course. The serum Ara-A peaked at 12 to 28μM at the end of infusion. Ara-ATP in blood peaked at 47 and 44 nmol/ml in 1st and 2nd course, respectively, and dATP at 190 and 110 nmol/ml, respectively. These findings suggest that the combination of dcf and Ara-A at the given dose is effective and safe for the treatment of T-ALL.
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Yu, A., Mendelsohn, J. & Matsurroto, S. INDUCTION OF COMPLETE REMISSION IN T-ALL BY DEOXYCO FARMYCIN (dcf) AND ARA-A: 236. Pediatr Res 19, 783 (1985). https://doi.org/10.1203/00006450-198507000-00256
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DOI: https://doi.org/10.1203/00006450-198507000-00256