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Dose-reduced combination of mitoxantrone, etoposide, and cytarabine (miniMEC) for relapsed and refractory acute leukemia. 2016
Chihiro Yamamoto, and
Shoko Ito, and
Kiyomi Mashima, and
Kento Umino, and
Daisuke Minakata, and
Ryoko Yamasaki, and
Yasufumi Kawasaki, and
Miyuki Sugimoto, and
Hirofumi Nakano, and
Masahiro Ashizawa, and
Kiyoshi Okazuka, and
Kaoru Hatano, and
Kazuya Sato, and
Iekuni Oh, and
Shin-Ichiro Fujiwara, and
Ken Ohmine, and
Takahiro Suzuki, and
Kazuo Muroi, and
Yoshinobu Kanda
a Division of Hematology, Department of Medicine , Jichi Medical University , Tochigi , Japan ;
The combination of mitoxantrone (MIT), etoposide (ETP), and cytarabine (Ara-C) (MEC) is a frequently used salvage therapy for acute leukemia, but has been associated with severe myelosuppression. Therefore, we investigated the miniMEC regimen with reduced doses of AraC and MIT. Thirteen ALL and 44 AML patients, all relapsed or refractory, received miniMEC, which consisted of MIT at 8 mg/m(2) for 3 d, ETP at 100 mg/m(2) for 5 d, and Ara-C at 100 mg/m(2) infused over 24 h for 7 d. CR + CRi was achieved in eight ALL patients (61.5%) and 16 AML patients (36.4%). Median duration of neutropenia was 30 d (range, 1-50). Thirty-one patients (54.4%) subsequently received allogeneic stem cell transplantation (SCT), and overall survival was significantly improved in this group (median OS 161 versus 481 d, p = 0.006). We concluded that miniMEC is a safe and effective bridging therapy to SCT.
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