TY - JOUR AU - Judith E. Karp, AU - Elizabeth Garrett-Mayer, AU - Elihu H. Estey, AU - Michelle A. Rudek, AU - B. Douglas Smith, AU - Jacqueline M. Greer, AU - D. Michelle Drye, AU - Karen Mackey, AU - Kathleen Shannon Dorcy, AU - Steven D. Gore, AU - Mark J. Levis, AU - Michael A. McDevitt, AU - Hetty E. Carraway, AU - Keith W. Pratz, AU - Douglas E. Gladstone, AU - Margaret M. Showel, AU - Megan Othus, AU - L. Austin Doyle, AU - John J. Wright, AU - John M. Pagel, PY - 2012/11/02 Y2 - 2024/03/29 TI - Randomized phase II study of two schedules of flavopiridol given as timed sequential therapy with cytosine arabinoside and mitoxantrone for adults with newly diagnosed, poor-risk acute myelogenous leukemia JF - Haematologica JA - haematol VL - 97 IS - 11 SE - Articles DO - 10.3324/haematol.2012.062539 UR - https://haematologica.org/article/view/6475 SP - 1736-1742 AB - Background Flavopiridol is a protein-bound, cytotoxic, cyclin dependent kinase inhibitor. A phase II trial of flavopiridol followed by ara-C and mitoxantrone with flavopiridol given by 1-h bolus for adults with newly-diagnosed, poor-risk acute myelogenous leukemia yielded 67% complete remission with median disease-free survival of 13.6 months.Design and Methods We compared bolus flavopiridol (50 mg/m2/day, Arm A) versus 'hybrid' flavopiridol (30 mg/m2 over 30 min followed by 40 mg/m2 over 4 h, Arm B) followed by ara-C and mitoxantrone in 78 patients (39 per arm) with newly diagnosed, poor-risk acute myelogenous leukemia. To mitigate imbalance, patients were stratified by presence or absence of secondary leukemia and therapy for antecedent disorder.Results Death at or before Day 60 occurred in 8% of patients per arm. Complete remission plus complete remission with incomplete recovery was 68% (Arm A, 62%; Arm B, 74%) overall, and 65% or over in both arms for patients with secondary leukemia and leukemia with adverse genetics. In Arm A 91% and in Arm B 86% of patients received chemotherapy and/or allogeneic transplantation in complete remission. Median overall survival for all remission patients has not been reached for either arm, with median disease free survival of 13.6 months for Arm A and of 12.0 months for Arm B.Conclusions Both flavopiridol schedules produce comparably encouraging results in adults with poor-risk acute myelogenous leukemia. Given the greater ease of bolus administration, we are conducting a randomized phase II study of bolus flavopiridol followed by ara-c and mitoxantrone versus conventional induction therapy for patients aged 70 years and under with intermediate or poor-risk acute myelogenous leukemia. This study is registered at www.clinicaltrials.gov as #NCT 00407966. ER -