Idarubicin in combination with intermediate-dose cytarabine and VP-16 in the treatment of refractory or rapidly relapsed patients with acute myeloid leukemia

Angelo M. Carella, Paolo Carlier, Ester Pungolino, Luigi Resegotti, Vincenzo Liso, Roberto Stasi, Marco Montillo, Pasquale Iacopino, Salvatore Mirto, Livio Pagano, Franco Leoni, Fabrizio M. Martelli, Francesco Di Raimondo, Adolfo Porcellini, Luigi De Riu, Anna M. Nosari, Renato Cimino, Eugenio Damasio, Eustachio Miraglia, Giuseppe FioritoniFrancesco Ricciuti, Mario Carotenuto, Maurizio Longinotti, Daniela Defazio, Paola Fazi, Franco Mandelli

Research output: Contribution to journalArticle

Abstract

Ninety-seven patients with refractory or relapsed acute myelogenous leukemia (AML), median age 37 years, received as salvage therapy a single course of idarubicin 6 mg/m2 as an intravenous (i.v.) bolus daily for 5 days, cytarabine (Ara-C) 600 mg/m2 i.v. for a period of 2 hours daily for 5 days and etoposide (VP-16) 150 mg/m2 for a period of 2 hours daily for 3 days (ICE protocol). Thirty-six patients were primarily resistant to standard inductive therapy with daunorubicin and Ara-C; 50 patients were in first relapse, three patients in second or third relapse, and eight patients in relapse after transplants. Forty-two (43%) out of 97 patients achieved complete remission, 11 patients died of infection or hemorrhage during induction, and 44 patients (45%) had resistant disease. Of the various variables examined, only disease status (i.e. refractory versus relapsed AML) was predictive for a significantly lower response rate. The median remission duration was 16 weeks; the overall median survival was 10 weeks. Nausea, vomiting, and oral mucositis were common but were rarely severe. No patient experienced treatment-related cardiac toxicity. In conclusion, the ICE protocol is a tolerable regimen providing effective antileukemic activity in patients with advanced AML. The evolution of this protocol in previously untreated patients with AML appears indicated.

Original languageEnglish
Pages (from-to)196-199
Number of pages4
JournalLeukemia
Volume7
Issue number2
Publication statusPublished - Feb 1993

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Idarubicin
Cytarabine
Etoposide
Acute Myeloid Leukemia
Therapeutics
Recurrence
Salvage Therapy
Stomatitis
Daunorubicin
Nausea
Vomiting

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

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Idarubicin in combination with intermediate-dose cytarabine and VP-16 in the treatment of refractory or rapidly relapsed patients with acute myeloid leukemia. / Carella, Angelo M.; Carlier, Paolo; Pungolino, Ester; Resegotti, Luigi; Liso, Vincenzo; Stasi, Roberto; Montillo, Marco; Iacopino, Pasquale; Mirto, Salvatore; Pagano, Livio; Leoni, Franco; Martelli, Fabrizio M.; Di Raimondo, Francesco; Porcellini, Adolfo; De Riu, Luigi; Nosari, Anna M.; Cimino, Renato; Damasio, Eugenio; Miraglia, Eustachio; Fioritoni, Giuseppe; Ricciuti, Francesco; Carotenuto, Mario; Longinotti, Maurizio; Defazio, Daniela; Fazi, Paola; Mandelli, Franco.

In: Leukemia, Vol. 7, No. 2, 02.1993, p. 196-199.

Research output: Contribution to journalArticle

Carella, AM, Carlier, P, Pungolino, E, Resegotti, L, Liso, V, Stasi, R, Montillo, M, Iacopino, P, Mirto, S, Pagano, L, Leoni, F, Martelli, FM, Di Raimondo, F, Porcellini, A, De Riu, L, Nosari, AM, Cimino, R, Damasio, E, Miraglia, E, Fioritoni, G, Ricciuti, F, Carotenuto, M, Longinotti, M, Defazio, D, Fazi, P & Mandelli, F 1993, 'Idarubicin in combination with intermediate-dose cytarabine and VP-16 in the treatment of refractory or rapidly relapsed patients with acute myeloid leukemia', Leukemia, vol. 7, no. 2, pp. 196-199.
Carella, Angelo M. ; Carlier, Paolo ; Pungolino, Ester ; Resegotti, Luigi ; Liso, Vincenzo ; Stasi, Roberto ; Montillo, Marco ; Iacopino, Pasquale ; Mirto, Salvatore ; Pagano, Livio ; Leoni, Franco ; Martelli, Fabrizio M. ; Di Raimondo, Francesco ; Porcellini, Adolfo ; De Riu, Luigi ; Nosari, Anna M. ; Cimino, Renato ; Damasio, Eugenio ; Miraglia, Eustachio ; Fioritoni, Giuseppe ; Ricciuti, Francesco ; Carotenuto, Mario ; Longinotti, Maurizio ; Defazio, Daniela ; Fazi, Paola ; Mandelli, Franco. / Idarubicin in combination with intermediate-dose cytarabine and VP-16 in the treatment of refractory or rapidly relapsed patients with acute myeloid leukemia. In: Leukemia. 1993 ; Vol. 7, No. 2. pp. 196-199.
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abstract = "Ninety-seven patients with refractory or relapsed acute myelogenous leukemia (AML), median age 37 years, received as salvage therapy a single course of idarubicin 6 mg/m2 as an intravenous (i.v.) bolus daily for 5 days, cytarabine (Ara-C) 600 mg/m2 i.v. for a period of 2 hours daily for 5 days and etoposide (VP-16) 150 mg/m2 for a period of 2 hours daily for 3 days (ICE protocol). Thirty-six patients were primarily resistant to standard inductive therapy with daunorubicin and Ara-C; 50 patients were in first relapse, three patients in second or third relapse, and eight patients in relapse after transplants. Forty-two (43{\%}) out of 97 patients achieved complete remission, 11 patients died of infection or hemorrhage during induction, and 44 patients (45{\%}) had resistant disease. Of the various variables examined, only disease status (i.e. refractory versus relapsed AML) was predictive for a significantly lower response rate. The median remission duration was 16 weeks; the overall median survival was 10 weeks. Nausea, vomiting, and oral mucositis were common but were rarely severe. No patient experienced treatment-related cardiac toxicity. In conclusion, the ICE protocol is a tolerable regimen providing effective antileukemic activity in patients with advanced AML. The evolution of this protocol in previously untreated patients with AML appears indicated.",
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AU - Carlier, Paolo

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AU - Resegotti, Luigi

AU - Liso, Vincenzo

AU - Stasi, Roberto

AU - Montillo, Marco

AU - Iacopino, Pasquale

AU - Mirto, Salvatore

AU - Pagano, Livio

AU - Leoni, Franco

AU - Martelli, Fabrizio M.

AU - Di Raimondo, Francesco

AU - Porcellini, Adolfo

AU - De Riu, Luigi

AU - Nosari, Anna M.

AU - Cimino, Renato

AU - Damasio, Eugenio

AU - Miraglia, Eustachio

AU - Fioritoni, Giuseppe

AU - Ricciuti, Francesco

AU - Carotenuto, Mario

AU - Longinotti, Maurizio

AU - Defazio, Daniela

AU - Fazi, Paola

AU - Mandelli, Franco

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