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Treatment of De Novo Acute Myelogenous Leukemia with Liposomal Doxorubicin Plus Ara-C



Treatment of De Novo Acute Myelogenous Leukemia with Liposomal Doxorubicin Plus Ara-C



Blood 100(11): Abstract No 4605, November 16



Anthracyclines are an important component in the initial therapy of AML and together with Ara-C have been the mainstays of the management in our institution. The low risk of cardiotoxicity and attempts to increase their activity can be made with liposomal formulation (CAELYX). We studied 8 newly diagnosed previously untreated AML patients, aged 32-58 (median 48 years). The standard dose of anthracycline was replaced for higher dose of liposomal doxorubicin in the induction and consolidation regimen. The schema for induction was Ara-C 100 mg/mt2/day CI x 7 days plus Caelyx 45 mg/mt2 days 1-3. Patients reach CR received 3 consolidations of Ara-C 1 Gr/mt2 twice daily on days 1-3 plus Caelyx 45 mg/mt2/days 1-2. The older patients (>55 yrs) received G-CSF for neutropenia. CR was achieved in 5 (62%) of the eight patients; 2 had refractory disease and one died for bleeding. Median number of days to ANC>500 in induction was 25 (range 21-35) and in consolidations 22 (range 21-30 days). No clinical cardiotoxicity was observed. Non-hematological toxicities were mild and 50% of the patients developed rash and hand-foot disease. Overal survival was 52% at 1 year and 26% at 2 years. In conclusion, in de novo AML adults, higher doses of liposomal doxorubicinj given as Caelyx together with standard dose Ara-C resulted in a higher (62%) CR rate. Future studies should be done to establish if liposomal doxorubicin could replace non-liposomal anthraciclines in the management of AML.

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