Preliminary Experience with Short Course High-Dose Mitoxantrone in Combination with High-Dose Cytarabine in Patients with Acute Leukemia and Blastic Phase of Chronic Myelogenous Leukemia

Mitoxantrone is effective therapy for patients with acute leukemia and blastic phase of chronic myelogenous leukemia (CML). In vitro mitoxantrone has a steep dose response curve, which suggests that higher doses given in a shorter duration may result in enhanced leukemic cell kill in vivo. Twenty-four patients with acute leukemia and blastic CML received mitoxantrone 20 mg/m2 I.V. daily × 2 with cytarabine 3 g/m2 I.V. once daily × 5 days. Diagnoses included 8 patients with previously untreated acute non-lymphocytic leukemia (ANLL), 9 patients with relapsed ANLL, 4 patients with refractory acute lymphoblastic leukemia (ALL) and 2 patients with blastic CML. Complete remission was achieved in 8 of 17 patients with ANLL, 1 of 4 patients with ALL and 0 of 2 with blastic CML. Extramedullary toxicity was acceptable and the median time to remission was 26 days (range 20-69). Short course high-dose mitoxantrone with high-dose cytarabine is effective and well-tolerated in patients with acute leukemia.