All issues > Volume 31(10); 1988

Original Article

J Korean Pediatr Soc. 1988;31(10):1328-1337. Published online October 31, 1988.

High-Dose Cytosine Arabinoside (HD Ara-C) Therapy for Refractory Acute Leukemia in Children.

Il Soo Ha¹, Hyo Seop Ahn¹, Chang Yee Hong¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Received: December 28, 1987;  Accepted: May 28, 1988.

Abstract

Eleven children with refractory acute leukemia were treated with high dose cytosine arabinoside (HD Ara-C), given at a dosage of 3 gm/m2 intravenously over about one hour every 12 hours for four to eight doses. The antileukemic effects were evaluable in nine of the patients, two with ALL, seven with ANLL. Six of the seven patients with ANLL attained complete remission, while neither of the two patients with ALL entered remission after the treatment. Significant bone marrow depression and fever followed the treatment in all patients, requiring intensive supportive cares. Pneumonia, urinary tract infection and sepsis were the most frequently documented infectious complications. Various nonhematologic toxicities, such as nausea, vomiting, hepatic dysfunction, diarrhea, skin rash and conjuctivitis, were noted in the given order of frequency, but central nervous system toxicity was not observed. Of the six patients who entered complete remission, two patients relapsed seven and forty seven weeks after remission respectively, and the other four patients are still in continuous remission for 14 + ~ 46 + weeks. We conclude that HD Ara-C therapy, in this author’s method, is an effective alternative regimen with relatively tolerable toxicities in children with refractory acute leukemias, especially ANLL.

Keywords :Refractory acute leukemia, High dose cytosine arabinoside