Mitozantrone and cytosine arabinoside as first‐line therapy in elderly patients with acute myeloid leukaemia

Abstract

We have prospectively evaluated a regimen of mitozantrone and cytosine arabinoside (Ara‐C) as first‐line therapy in elderly patients with acute myeloid leukaemia (AML). One hundred and four patients with a median age of 68 (range 60–81) were studied, in whom 86 had de‐novo AML, and 18 had preceding myelodysplasia or secondary AML. Complete remission was achieved in 64% of de‐novo cases, in 28% of MDS/secondary cases, and in 58% overall. The incidence of early death within 28 d of chemotherapy was 11%. The median disease‐free survival (DFS) was 11 months with an actuarial DFS of 15% at 43 months. The median overall survival was 9 months with an actuarial survival of 10% at 44 months. The incidence of non‐haematological toxicity was acceptably low, and usually of mild to moderate severity. Quality of life was improved, or unchanged, in 90% of responders. We conclude that mitozantrone and ara‐C is an effective and well‐tolerated regimen which produces high remission rates in elderly patients with AML.