MEC (MITOXANTRONE, ETOPOSIDE AND INTERMEDIATE-DOSE CYTARABINE) - AN EFFECTIVE INDUCTION REGIMEN FOR PREVIOUSLY UNTREATED ACUTE NONLYMPHOCYTIC LEUKEMIA

Twenty-three patients with acute non lymphocytic leukemia (ANLL), were treated with a single-6 day course of Mitoxantrone 6mg/m(2)/day, Etop oside 80mg/m(2)/day and intermediate dose Cytarabine (ara-C) 1g/m(2)/d ay (MEG). Patients who achieved complete remission (CR) were submitted to a 4-day-course of MEC as consolidation. Seventeen patients (73.9%) obtained CR, five patients (22.7%) were resistant to the treatment an d one patient died during induction. Median remission duration was 11 months; overall median survival was 16 months. Relapses occurred in 11 patients; eight patients are still alive: 6 in 1st, 2 in 2nd CR (mean survival 20.1 months, range 17-26). All patients experienced severe m yelosuppression comparable to that observed after classical induction cycles including ara-C in continuous intravenous infusion; none, howev er, died of infection. Non-hematologic toxicity was minimal; in partic ular, neurotoxicity was not observed. According to our results, the ME C regimen, which was previously demonstrated to be active in refractor y patients, represents an effective induction treatment in ANLL, with an acceptable toxicity.