| Literature DB >> 9734653 |
E Wattel1, E Solary, B Hecquet, D Caillot, N Ifrah, A Brion, B Mahé, N Milpied, M Janvier, A Guerci, H Rochant, C Cordonnier, F Dreyfus, A Buzyn, L Hoang-Ngoc, A M Stoppa, N Gratecos, A Sadoun, A Stamatoulas, H Tilly, P Brice, F Maloisel, B Lioure, B Desablens, P Fenaux.
Abstract
Intensive chemotherapy produces a lower complete remission (CR) rate in the myelodysplastic syndromes (MDS) than in de novo acute myeloid leukaemia (AML), possibly due in part to a higher incidence of P glycoprotein (PGP) expression in MDS blast cells. We designed a randomized trial of intensive chemotherapy with or without quinine, an agent capable of reverting the multidrug resistance (mdr) phenotype, in patients aged < or = 65 years with high-risk MDS. Patients were randomized to receive mitoxantrone 12 mg/m2/d days 2-5 + AraC 1 g/m2/12 h days 1-5, with (Q+) or without (Q-) quinine (30 mg/kg/d). 131 patients were included. PGP expression analysis was successful in 91 patients. In the 42 PGP-positive cases, 13/25 (52%) patients in the Q+ group achieved CR, compared to 3/17 (18%) patients in the Q- group (P = 0.02) and median Kaplan-Meier survival was 13 months in the Q+ group, and 8 months in the Q- group (P = 0.01). No life-threatening toxicity was observed with quinine. In conclusion, the results of this randomized study show that quinine increases the CR rate and survival in PGP-positive MDS cases treated with intensive chemotherapy.Entities:
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Year: 1998 PMID： 9734653 DOI： 10.1046/j.1365-2141.1998.00870.x
Source DB: PubMed Journal: Br J Haematol ISSN： 0007-1048 Impact factor: 6.998