High‐dose cytosine arabinoside and idarubicin treatment of chronic myeloid leukemia in myeloid blast crisis

Abstract

Abstract Chronic myeloid leukemia in myeloid blast crisis (CML‐MBC) is highly resistant to standard induction chemotherapy regimens. Anecdotal results from previous clinical trials support the concept of dose escalation in patients with CML‐MBC. Eight patients with CML‐MBC were treated with cytosine arabinoside (Ara‐C) 1.5–3.0 g/m 2 intravenously over 1 hr every 12 hr for 12 doses and idarubicin 12 mg/m 2 intravenously daily for 3 days. Sixteen previous reports describing the use of Ara‐C‐based chemotherapy regimens in patients with CML‐MBC were also reviewed. Our patients' median age was 62 years (range, 42–69 years). One patient achieved complete hematologic remission (95% confidence interval, 0.3%, 53%). The median survival for our patients was 7.3 months. These results were not different from previous published reports using Ara‐C‐based chemotherapy regimens to treat CML‐MBC. In summary, the combination of high‐dose Ara‐C and idarubicin did not improve the overall prognosis of patients with CML‐MBC. Innovative approaches need to be explored for this patient population. Am. J. Hematol. 67:119–124, 2001. © 2001 Wiley‐Liss, Inc.