Abstract
Seventy-two adult patients with previously untreated acute myeloid leukemia received the CHA regimen as induction chemotherapy: CCNU 80 mg/m 2 on day 1, Adriamycin® 35 mg/m 2 i.v. on days 1, 2 and 3, and continuous infusion of cytarabine 100 mg/m 2/24 h from day 1 to 10. Forty-nine patients ( 68%) presented at least one of the following symptoms: acral erythema with dysesthesias in the palms and/or soles ( 39%); cholestatic hepatitis ( 39%); profuse sterile diarrhea associated with abdominal distention ( 33%); acute cerebellar dysfunction ( 32%) and non-cardiogenic pulmonary edema ( 21%). Most of these toxic symptoms appeared 8–20 days after the first dose. As these clinical features were absent or exceptional in patients treated with another regimen within a controlled trial, they are reported as toxic side-effects of the chemotherapy regimen. Acral erythema was found to be predictive of complete remission ( P < 0.01, odds ratio: 6.33); neurotoxicity was prognostic for death in aplasia ( P < 0.05); the absence of any of the five symptoms was associated with failure of the induction regimen ( P < 0.02).
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