Low-dose long-term oral idarubicin in maintenance treatment of elderly acute myeloid leukemia

Low-dose long-term oral IDA may play a role in maintainance treatment of elderly patients with AML; in fact, continuous exposure to IDA and IDAol could be efficacious in the disease control possibly inducing cell-differentiation and/or apoptosis. We enrolled 25 previous responder patients in standar...

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Published inHaematologica (Roma) Vol. 82; no. 5; pp. 4 - 8
Main Authors MUSSO, M, PORRETTO, F, CRESCIMANNO, A, BONDI, F, POLIZZI, V, SCALONE, R, TOLOMEO, M, MARIANI, G
Format Conference Proceeding Journal Article
LanguageEnglish
Published Pavia Haematologica 01.09.1997
Subjects
Acute Disease
Administration, Oral
Aged
Aged, 80 and over
Antibiotics, Antineoplastic - therapeutic use
Antineoplastic agents
Biological and medical sciences
Chemotherapy
Dose-Response Relationship, Drug
Female
Humans
Idarubicin - therapeutic use
Leukemia, Myeloid - drug therapy
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
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Summary:Low-dose long-term oral IDA may play a role in maintainance treatment of elderly patients with AML; in fact, continuous exposure to IDA and IDAol could be efficacious in the disease control possibly inducing cell-differentiation and/or apoptosis. We enrolled 25 previous responder patients in standard induction therapy to receive maintenance oral IDA 5 mg daily on days 1-14 at 2-week intervals for at least 6 months. We also evaluated the cell-cycle and apoptosis in leukemic cells from patients after IDA administration and, as a control, from HL60 lines exposed to IDA and IDAol in vitro. Long-term long-dose IDA was well-tolerated. Neutrophil and platelet count never below under 1 x 10(9)/L and 50 x 10(9)/L respectively in CR patients, and no infectious complications were encountered. Non-hematological toxicity was also acceptable: easily controlled nausea and vomiting, non-recorded diarrhea or mucositis were reported. The convenience of oral administration contributed to excellent compliance. DNA analysis performed in vivo after IDA and IDAol exposure showed an increase of G2/M cell frequencies and evidence of sub-G1 peak. In conclusion, long-term low doses of oral IDA would appear valuable as a maintenance regimen for elderly patients. Our results seem to confirm the preliminary hypothesis that IDA + IDAol induce an increase of apoptosis in leukemic cells.
ISSN:0390-6078
1592-8721