Abstract
We report here the therapeutic results of a combination of idarubicin/cytarabine treatment (IDA : 5 mg/m2, 30 minutes infusion for 3-6 days, CA : 1 g/m2, 6 hours infusion for 3-6 days) in 7 cases of refractory acute leukemia (AML, 3 ; ALL, 4) in childhood. When treated, all cases had active disease, with 2 induction failures and 5 relapses (1st, 3 ; 2nd, 1 ; 4th, 1). Following an induction treatment, 4 patients showed good response (GR), two of which maintained GR after consolidation by using the same IDA/CA. As for adverse effects of this therapy, bone marrow suppression and infections were noted in all cases. Severe leukocytopenia with a nadir of WBC ≤200/μl and delayed recovery over a period of median 15 days (range 7-30 days) occurred at every course of treatment. Other toxicities included mild nausea, vomiting, and liver dysfunction. Cardiac dysfunction was also observed in 2 cases. The IDA/CA therapy was thought to be useful to attain a GR in childhood refractory acute leukemia, but careful management is needed for infectious complications and cardiac toxicity.
