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The use of modified MidAC regimen in the treatment of adult patients with de novo Acute Myeloid Leukemia in Baghdad Teaching Hospital

Authors: Mazin Abbas Shubber --- Ali Almothaffar
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2011 Volume: 1 Issue: 1 Pages: 13-21
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Consolidation chemotherapy is an important concern in maintaining remissionin acute myeloid leukemia (AML) .Objectives: We intended to evaluate the efficacy of using modified MidAC regimen in thetherapy of adult AML patients .Patients & Methods :Twenty-six patients (mean age, 25 years; range, 17 to 45 years) with denovo AML were given induction regimen according to the AML subtype .Patientswho failed induction, were received modified MidAC as salvage therapy .All patientswho achieved complete remission (CR) were assigned to receive 3 successivecourses of modified MidAC as a consolidation treatment .Results :A total of 21 (80%) patients went into CR after one induction regimen .In the rest 5(20%), 3 (60 )%of them enter CR after re-induction with modified MidAC, and 2(40 )%died .Total 24 patients assigned for consolidation therapy .After completingthe 3 consolidation courses, 21 (88 )%of them were maintained in remission while 3(12 %)died .The median duration of follow up was 11.7 months .At the end of thestudy, 13 patients) 54 )%were in CR and 8 (38 )%relapsed .The median overallsurvival) OS )is 20 months and the 2 years OS is 41.%Median disease-free survival(DFS )is 17 months and the 2 years DFS is 37 .%Median survival after relapse was2.5 months .Main toxicities after modified MidAC regimen were myelosuppression,GIT complications and sepsis .Conclusion :Modified MidAC regimen is an option as a consolidation or as a salvage therapyin the treatment of adult AML patients with minimal difference in the rate of toxicitywhen compared with other high-dose regimens .

Keywords

AML treatment --- consolidation --- MidAC

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