Treatment of adult acute leukemia with arabinosylcytosine and thioguanine.

Abstract

Forty unselected adults with acute leukemia were treated with CA (2–3 mg/kg) by daily rapid intravenous injection and TG (2.5 mg/kg) orally. Two patients were judged to have had an inadequate trial, having died after 3 and 4 days. Of 38 adequately treated patients, 2 had acute lymphoblastic and 36 acute myeloblastic, monoblastic, or myelomonoblastic leukemia. Twenty-eight patients had had previous chemotherapy (19 with either CA or 6-MP alone) but had failed to respond or had relapsed and were refractory. The 38 adequately treated patients had 1 or more courses of CA and TG of 8–32 days each as limited by individual tolerance. The drugs caused moderate or severe pancytopenia and marrow hypoplasia in all but 3 patients treated. Twenty-one of 38 patients had remission with M-1 marrows lasting an average 6 (1.5–13) months with 6 patients still in remission. Seventeen of 21 patients had H-1 peripheral blood ratings (normal platelet, leukocyte and hemoglobin values) and 4 had H-2 ratings, all because of low hemoglobin. Twenty patients in remission were given maintenance therapy; the dosage varied but is currently TG 2.5 mg/kg 4–5x/wk + CA 2–3 mg/kg 1-2x/wk.