Abstract
Thirty adults with active AML were randomly assigned to treatment with a sequence of cyclophosphamide (CY), 15 mg/kg IV, vincristine (VCR) 0.025 mg/kg IV given 24 hours later, and a 48-hour IV infusion of arabinosyl cytosine (ara-C) begun 12 hours after VCR(CVC), or 4 doses of CY, 25 mg/kg IV given on successive days. Two courses of each therapy were repeated at 14-day intervals providing sufficient recovery of normal marrow elements. Both regimens induced remissions. The overall complete response rate was 50%. 3H-thymidine (3H-TdR) and 3H-arabinosylcytosine (3H-ara-C) labeling indices of tumor cells were performed before treatment. High labeling indices for both compounds correlated with clinical responsiveness, but a high index for either compound alone was insufficient. Sequential labeling studies were completed in 9 patients with high density tumor (marrow replacement) treated with CVC. There was no consistent increase in 3H-TdR or 3H-ara-G labeling indices 24 hours after CY.
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