Clinical activity of sequential flavopiridol, cytosine arabinoside, and mitoxantrone for adults with newly diagnosed, poor-risk acute myelogenous leukemia

Judith E. Karp, Amanda Blackford, B. Douglas Smith, Katrina Alino, Amy Hatfield Seung, Javier Bolaños-Meade, Jacqueline M. Greer, Hetty E. Carraway, Steven D. Gore, Richard J. Jones, Mark J. Levis, Michael A. McDevitt, L. Austin Doyle, John J. Wright

Research output: Contribution to journalArticle

Abstract

Flavopiridol, a cyclin-dependent kinase inhibitor, is cytotoxic to leukemic blasts. In a Phase II study, flavopiridol 50mg/m2 was given by 1-h infusion daily×3 beginning day 1 followed by 2g/m2/72h ara-C beginning day 6 and 40mg/m2 mitoxantrone on day 9 (FLAM) to 45 adults with newly diagnosed acute myelogenous leukemia (AML) with multiple poor-risk features. Thirty patients (67%) achieved complete remission (CR) and 4 (9%) died. Twelve (40%) received myeloablative allogeneic bone marrow transplant (BMT) in first CR. Median OS and DFS are not reached (67% alive 12.5-31 months, 58% in CR 11.4-30 months), with median follow-up 22 months. Sixteen received FLAM in CR, with median OS and DFS 9 and 13.1 months, and 36% alive at 21-31 months. Short OS and DFS correlated with adverse cytogenetics, regardless of age or treatment in CR. The addition of allogeneic BMT in CR translates into long OS and DFS in the majority of eligible patients.

Original languageEnglish (US)
Pages (from-to)877-882
Number of pages6
JournalLeukemia Research
Volume34
Issue number7
DOIs
StatePublished - Jul 1 2010

Keywords

  • AML
  • Flavopiridol
  • Poor risk
  • Timed sequential therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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