Low dose cytarabine in acute myeloid leukemia: 41 cases.

This is a retrospective study on the use of cytarabine at low doses in acute myeloid leukemias in 41 patients. Four groups of AML are included: group A: 19 cases of de novo AML in elderly patients; group BI ten cases of AML in relapse; group C:five cases of AML refractory to previous treatment and group Dr seven cases of secondary AML. Cytarabine was given subcutaneously at the dose of 10 mg/m(2) of body surface, for 2! days per month for the first course; then 15 days per month for the following courses. The response rates were 42, 20, 0, and 43% respectively for the A, B, C, and D groups. A complete remission was attained in only 15% (sir patients). Extra haematological tolerance was excellent. Infection complications were noted in 66%, whereas a severe neutropenia was observed in 34% of patients. Hemorragic complications were more rare (20% of patients). The mean duration of complete remission was 10 months. The median survival war 10.5 months (2 to 31 months)for the responder patients, and 2.4 months (1 to 7 months)for the non-responders. Cytarabine at low doses seems to be a good indication for first intention treatment of AML in elderly patients. it does not give a bone marrow aplasia, the infection and hemorragic episodes are less numerous than with conventional dose chemotherapy, the life quality is improved and treatment at home is often possible.