Mitoxantrone, etoposide, carboplatinum and ara-C combination therapy (Meca) in refractory and relapsed acute leukemia

The present study was undertaken to assess the feasibility, toxicity and an tileukemic activity of sequential chemotherapy including mitoxantrone, etop oside, carboplatin and intermediate-dose cytarabine in adult patients with refractory and relapsed acute myelogenous (AML) or lymphoid (ALL) leukemia. Fifty-one patients with poor-risk AML and ALL received 64 courses of MECA therapy. The overall response in the entire group was 51% (43% complete rem ission). The stage of the disease (relapsed or primarily refractory) and th e age of the patients did not strongly affect the response rate. MECA thera py was more effective in ALL than in AML, and in those patients who present ed at salvage treatment with a bone marrow infiltration lower than 25% blas ts. Hematological and extra-hematological toxicities were tolerable and the re were 6 deaths related to the treatment (11%). The incidence of documente d infectious episodes was 71%. MECA therapy is a safe treatment and has a h igh antileukemic activity in relapsed and primarily refractory AML or ALL.