Background : Advances in chemotherapy regimens and supportive care provided
significant improvement in complete remission rate up to 55% to 72% in patients with
acute myelogenous leukemia(AML). However, only 15% to 20% of all adults found to
have AML may be expected to be alive 2 years following their diagnosis. The efficacy
of combined chemotherapy of mitoxantrone, cytosine arabinoside and etoposide(MAV)
regimens have been evaluated in adult patients with AML.
Methods: Thirteen patients with previously untreated AML received initial induction
chemotherapy with mitoxantrone, 10㎎/㎡/day, in 30 minute infusion on day 1 to 3,
cytosine arabinoside(Ara-C), 200㎎/㎡/day, in continuous intravenous infusion on day 1
to 7, and etoposide(VP-16), 75㎎/㎡/day, in 90 minute infusion on day 1 to 7. The
second course of treatment was permitted of leukemia persisted on 29 days after
treatment for patients with partial remission. Two cycles of consolidation chemotherapy
was performed at least 4 weeks following remission; mitoxatrone, 10㎎/㎡/day for 1day,
Ara-C, 200㎎/㎡/day, continuous intravenous infusion for 3 days and VP-16, 75㎎/㎡/day,
for 3 days.
Results: Nine of 13(69%) patients achieved complete remission with median remission
duration of 22.2 weeks(range 11∼42＋/day weeks). The median periods of
granulocytopenia(granulocyte<500/μL) and thrombocytopenia(platelet < 10 5
/μL) were 25 days and 22 days, respectively. Two patients died early in the initial
induction therapy due to sepsis and intracranial hemorrhage. Toxicities were primarily
fever, stomatitis and infection.
Conclusion: Combination chemotherapy with mitoxantrone, Ara-C and VP-16 is an
effective regimen for AML with acceptable toxicity.

Keywords: Acute Myelogenous Leukemia, Combination Chemotherapy, Mitoxantrone, Cytosine arabinoside, Etoposide