Treatment of refractory acute leukemia with cyclophophamide,Ara-c,and topotecan combination regimen

Objective:To observe the effects and side-effects of cyclophophamid,cytarabine,topotecan(CAT) combination regimen for the treatment of refractory acute myeloid leukemia(AML). Method:Twenty-one patients with refractory AML were treated with CAT chemotherapy and the total courses were 32. Result:Two patients died of sepsis,8 patients achieved complete remission(CR),4 patients achieved partial remission.The total response rate was 63.16%(12/19 cases).Two out of 8 patients achieving CR accepted allogeneic bone marrow transplantation.Whether the reduction of blast cells at 7-14 days after the termination of first induction treatment reached more than 50% can be taken as a significant index to estimate the survival of the refractory AML.The major side-effect of CAT regimen was bone marrow suppression. Conclusion:CAT regimen may be an effective and tolerable choice for refractory acute leukemia patients.The patients achieving CR should receive allogeneic bone marrow transplantation as early as possible.