ABSTRACT
PURPOSE: The effect of salvage chemotherapy using mitoxantrone based regimen for refractory AML (RAML) was analyzed. METHODS: Between January 1990 and March 2001, we treated 26 RAML. Ten patients received salvage chemotherapy with mitoxantrone based regimen and 16 patients with regimen devoid of mitoxantrone. RESULTS: Of total 54 AML patients treated during this period, 48 cases were available for analysis. RAML patients were 26 cases (54.1%) and M:F ratio was 2.3:1. FAB M2 and M4 were 8 each, and 7 cases were M7. There were 1 case of M1, M5 and M6 each. Eleven (42.3%) of them showed chromosomal abnormalities with variable karyotypes. Patients on mitoxantrone regimen all achieved complete remission (CR), while mitoxantrone devoid regimen achieved CR in only 56.2%. Allogeneic bone marrow transplantation was done in 5 cases (19.2%) of RAML, who are all alive with the median survival duration of 18 months. In mitoxantrone based regimen, 4 cases developed congestive heart failure and 5 had severe infection due to prolonged myelosuppression. In non-mitoxantrone group, 5 of 7 cases who failed to achieve CR died of sepsis. CONCLUSION: The mortality of RAML patients who are refractory to salvage chemotherapy remains very high. This study suggests that mitoxantrone based chemotherapy is effective in achieving complete remission as well as in prolonging survival in RAML patients.