A COMBINATION CHEMOTHERAPY WITH LOW-DOSES OF CYTARABINE AND ETOPOSIDEFOR HIGH-RISK MYELODYSPLASTIC SYNDROMES AND THEIR LEUKEMIC STAGE - A PILOT-STUDY

BACKGROUND. Even now, no definitely effective therapy is inducted to h igh risk myelodysplastic syndromes (MDS) and their leukemic stage (MDS -AML) except bone marrow transplantation. METHODS, Ten patients with h igh risk MDS and 6 with MDS-AML were treated with daily low doses of c ytarabine (10 mg/m(2)/12h, infused over 2h) etoposide (50 mg/m(2)/day, infused over 2h). RESULTS, Fourteen of these patients were finally ev aluated among whom 6 with high risk MDS and 3 with MDS-AML (64.3%) had complete remission, and 2 with high risk MDS (14.3%) achieved partial remission after this chemotherapy for 9 to 21 days. Three of 11 respo nders were resistant to the prior chemotherapies with single and low d ose cytotoxic agents including cytarabine, etoposide, or aclarubicin. Although all of the patients who could be assessed developed severe ma rrow hypoplasia after chemotherapy, the nonhematologic side effects we re mild enough to be tolerated. CONCLUSIONS, Tills combination chemoth erapy must be effective and useful in high risk MDS and MDS-AML not on ly without prior chemotherapy but in cases which have been resistant t o single and low dose oncostatic agent. (C) 1996 American Cancer Socie ty.