Amsacrine, cytarabine and etoposide in the treatment of bad prognosis acute myeloid leukemia.

Thirty-seven patients (median age 50 yr, range 17-82) with acute myeloid leukemia (AML) received intensive induction treatment with amsacrine, cytarabine and etoposide in combination. Nine of the patients were refractory to previous induction therapy, 15 relapsed during or after treatment with daunorubicin and cytarabine, 13 had AML after previous hematologic disorders. Eleven of the patients with AML after previous hematologic disorders had been treated with cytotoxic drugs. Toxicity was substantial, but complete remission (CR) was achieved in 33% of patients with refractory AML, 47% of patients with AML in relapse, 54% of patients with AML after antecedent blood disorder. CR duration was 15 weeks (median). Patients with AML of FAB types M4 and M5 entered remission more often (70%) than patients with other AML types (37%).