Sequential Homoharringtonine and Interferon- in the Treatment of Early Chronic Phase Chronic Myelogenous Leukemia
1999; Elsevier BV; Volume: 93; Issue: 12 Linguagem: Inglês
10.1182/blood.v93.12.4149.412k10_4149_4153
ISSN1528-0020
AutoresSusan O’Brien, Hagop M. Kantarjian, Charles Koller, Eric J. Feldman, Miloslav Beran, Michael Andreeff, Sergio Giralt, Bruce D. Cheson, Michael J. Keating, Emil J. Freireich, Mary Beth Rios, Moshe Talpaz,
Tópico(s)Eosinophilic Disorders and Syndromes
ResumoHomoharringtonine (HHT) is a novel plant alkaloid that produced a complete hematologic remission (CHR) in 72% of patients with late chronic phase chronic myelogenous leukemia (CML). Cytogenetic (CG) remissions were noted in 31%. In this study, six courses of HHT were administered to 90 patients with early chronic phase CML (< 1 year from diagnosis). Patients then received interferon- (IFN-) with a target dose of 5 MU/m2 daily. Results were compared with those in a prior group of patients treated with IFN-–based therapy between 1982 and 1990. Ninety-two percent of patients achieved CHR with HHT; CG responses were observed in 60% and were major in 27%. Both CHR and CG response rates were significantly higher than those seen in historical control patients after 6 months of IFN- therapy. After receiving HHT, patients required lower doses of IFN- to maintain a CHR. The median dose delivered was 2.4 MU/m2. This reduction in IFN- dose was associated with a lower incidence of myalgia and gastrointestinal (GI) disturbances than that seen in patients treated at the 5 MU/m2 dose. Overall, CG responses were seen in 66% of the patients who received HHT and IFN- compared with 61% of the historical control patients. HHT is a very effective treatment of early chronic phase CML, and ongoing trials are investigating the simultaneous administration of HHT and IFN-, as well as that of HHT and low-dose cytosine arabinoside in patients failing IFN- therapy.
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