Outcomes of Six-Dose High-Dose Cytarabine as a Salvage Regimen for Patients with RelapsedRefractory Acute Myeloid Leukemia

الملخص EN

Relapsed/refractory acute myeloid leukemia (RR-AML) is associated with poor prognosis and long-term disease-free survival requires allogeneic hematopoietic cell transplantation (allo-HCT).

Limited data exists, regarding the optimal regimen to obtain remission prior to allo-HCT.

Single agent high-dose cytarabine (10–12 doses administered every 12 hours) has been previously used as induction therapy.

Six-dose high-dose cytarabine (HiDAC-6), commonly used as a consolidation regimen, has never been evaluated as induction therapy.

We present a retrospective review of 26 consecutive patients with RR-AML receiving single agent cytarabine 3 g/m2 intravenously every 12 hours on days 1, 3, and 5 for a total of six doses (HiDAC-6).

Median follow-up for surviving patients was 10.4 months (range 1.6–112.2 months).

Complete remission was obtained in 62% (54% CR and 8% CRi) of the patients.

The median relapse-free survival (RFS) was 22.3 months (range 0.7–112 months), event-free survival (EFS) was 4.7 months (range 0.5–112 months), and the overall survival (OS) was 9.6 months (range 1–112 months).

Thirty-five percent of patients were able to subsequently proceed to allo-HCT.

Treatment-related toxicities included neutropenic fever (38%), infection (35%), neurotoxicity (8%), and skin toxicity (8%).

This is the first study to demonstrate HiDAC-6 as an active treatment option for younger patients with RR-AML which can effectively serve as a bridge to allo-HCT without significant toxicity.