Carboplatin plus cytarabine in the treatment of high-risk acute myeloblastic leukemia

Thirty-one patients (20 male and 11 female; median age 51 years (16-79)) wi th high-risk acute myeloblastic leukemia (AML) (20 refractory AML and 11 se condary AML (s-AML) (four to myelodysplastic syndrome, five to chemo/radiot herapy, one to aplastic anemia and one blastic chronic myelogenous leukemia (B-CML)) were treated with CBDCA (300 mg/m(2)/day x 5 days in continuous i .v. infusion) plus intermediate-dose Ara-C (500 mg/m(2)/day x 3 days in rap id i.v, infusion). Nine patients (29%) achieved CR (five s-AML (three myelo dysplastic syndromes, one CML and one ALL) and four refractory AML) and 11 patients had resistant disease. There were 11 early deaths (35%). Median di sease-free survival of the nine responders was 4 months. The main toxicity was hematological, febrile episodes took place in nearly all the patients ( 96%). The CBDCA plus Ara-C regimen showed an evident antileukemic activity in high-risk leukemia. However, the lack of long-term disease-free survivor s shows the need for innovative postremission strategies. The high initial response rate seen in AML secondary to myelodysplastic syndromes (MDS) warr ants further investigation of CBDCA in combination regimens for MDS patient s.