Arabinosyl Cytosine: A Useful Agent in the Treatment of Acute Leukemia in Adults

• Published in: Blood Vol. 32; no. 4; pp. 507 - 523
• Main Authors: Ellison, Rose Ruth, Holland, James F., Weil, Marise, Jacquillat, Claude, Boiron, Michel, Bernard, Jean, Sawitsky, Arthur, Rosner, Fred, Gussoff, Bernard, Silver, Richard T., Karanas, Arthur, Cuttner, Janet, Spurr, Charles L., Hayes, Donald M., Blom, Johannes, Leone, Louis A., Haurani, Farid, Kyle, Robert, Hutchinson, J.L., Forcier, R. Jackson, Moon, John H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-10-1968
• Subjects: Adolescent; Adult; Aged; Blood Cell Count; Blood Platelets; Blood Transfusion; Bone Marrow Examination; Cell Nucleus; Cytarabine - administration & dosage; Cytarabine - adverse effects; Cytarabine - therapeutic use; Drug Tolerance; Erythrocytes; Female; Humans; Leukemia, Lymphoid - drug therapy; Leukemia, Myeloid - drug therapy; Leukemia, Myeloid, Acute - drug therapy; Leukocyte Count; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Non-Hodgkin - drug therapy; Male; Middle Aged; Prednisone - therapeutic use
• DOI: 10.1182/blood.V32.4.507.507
• EISSN: 1528-0020
• ISSN: 0006-4971

Arabinosyl cytosine (ara-C), a synthetic pyrimidine nucleoside related to the normal metabolites cytidine and deoxycytidine, has been found capable of producing marrow remission at tolerable doses in acute myelocytic and acute lymphocytic leukemia in adults. There were 16 per cent remissions complete in all aspects, 3 per cent complete except for hemoglobin level, and 6 per cent partial remissions among 180 adults with acute myelocytic leukemia treated with any one of 8 variants of infusion duration or daily dose of ara-C. Twenty-four per cent of 37 adults with acute lymphocytic or unclassified leukemia had complete or partial remissions. The comparison of 1, 4, 12 and 24 hours infusion of ara-C (to total dose tolerated) does not show significant superiority for any one group. The complete remission rate with 1 or 12 hour infusions, however, is 25 per cent (superior to that obtained with 6-mercaptopurine) and the recommended schedule of treatment for ara-C based on these data is, therefore, daily infusions of 100 or 50 mg./m.2 in one hour for approximately 3 to 6 weeks followed by maintenance therapy of once weekly subcutaneous injection of 30 mg./m.2 of ara-C. Platelet transfusions should be available when ara-C is used.