Abstract
We report the results of a regimen of mitoxantrone on days 1 to 3, etoposide on days 8 to 10 and cytarabine on days 1 to 3 and 8 to 10 (EMA) in six children with AML. Of the six patients, three were resistant to induction therapies (IF : induction failure), two initially showed relapse and one was initially in complete remission (CR). After one course of EMA, four of the five patients who received EMA as an induction therapy achieved CR. Three patients received autologous (one) or allogeneic (two) bone marrow transplantations (BMT). These three patients have survived without disease for 20 to 60 months. One patient who could not achieve CR with EMA underwent transplantation with positively selected CD34+ cells from HLA-mismatched donor's peripheral blood after EMA. However, he died after bone marrow relapse. One patient who was treated with consolidation therapy has shown disease-free survival (DFS) for 63 months. The period that neutrophil count was under 500/μl continued for 28-58 days (mean : day 35.4± 10.7). Sepsis and pneumonia were seen in two patients and one patient, respectively. Thus, four of five patients who had been resistant to (re) -induction chemotherapy achieved CR. This result suggests that EMA is useful for previously treated patients with refractory AML despite extensive therapies.
