High-dose cytosine arabinoside and idarubicin treatment of chronic myeloidleukemia in myeloid blast crisis

Chronic myeloid leukemia in myeloid blast crisis (CML-MBC) is highly resist ant to standard induction chemotherapy regimens. Anecdotal results from pre vious clinical trials support the concept of dose escalation in patients wi th CML-MBC, Eight patients with CML-MBC were treated with cytosine arabinos ide (Ara-C) 1.5-3.0 g/m(2) intravenously over 1 hr every 12 hr for 12 doses and idarubicin 12 mg/m(2) intravenously daily for 3 days. Sixteen previous reports describing the use of Ara-C-based chemotherapy regimens in patient s with CML-MBC were also reviewed. Our patients' median age was 62 years (r ange, 42-69 years). One patient achieved complete hematologic remission (95 % confidence interval, 0.3%, 53%), The median survival for our patients was 7.3 months. These results were not different from previous published reports using Ara-C-based chemotherapy r egimens to treat CML-MBC. In summary, the combination of high-dose Ara-C an d idarubicin did not improve the overall prognosis of patients with CML-MBC , Innovative approaches need to be explored for this patient population. Am . J. Hematol. 67:119-124, 2001, (C) 2001 Wiley-Liss, Inc.