Failure of lithium to limit neutropenia significantly during induction therapy of acute myelogenous leukemia. A Southeastern Cancer Study Group study.

Abstract

Eight-five patients receiving cytosine arabinoside and daunorubicin as induction therapy of acute myelogenous leukemia were randomly assigned to receive lithium carbonate 300 mg t.i.d. or no lithium. Treatment groups were similar with respect to age, gender, baseline granulocyte counts, and patients who were febrile at presentation. Granulocyte nadirs below 100/cu mm were observed in nearly all patients. The duration of neutropenia was not significantly shorter for patients receiving lithium (23.3 days) than for controls (24.1 days), p = 0.18. The incidence of fever and infection were similar in the two groups. The incidence of complete remission was significantly lower in patients receiving lithium, 75% vs, 49%, p = 0.012, although no physiologic explanation attributable to lithium could be established. Toxicity was minimal, although lithium was discontinued in 44% of patients over the age of 50. The administration of lithium does not have apparent clinical efficacy as an adjuvant to therapy in acute myelogenous leukemia.