Objective: To evaluate the efficacy and toxicity of topotecan-based combined chemotherapy for refractory or relapsed hematologic malignancies.
Methods: Twenty-one patients with refractory or relapsed acute leukemia (AL), non-Hodgkin's lymphoma (NHL) or high risk myelodysplastic syndrome (MDS) were treated by topotecan with cytarabine, amsacrine or cyclophosphamide. All patients received a single course as salvage therapy.
Results: The overall response rate of one course was 61.9% with 9/21 (42.9%) CR and 4/21 (19%) PR. Severe myelosuppression was observed in all patients. Agranulocytic time was 12.6 days in AL and 7.5 days in NHL. Sixteen of 21 patients received G-CSF 300 micro g/d All patients received supportive treatment of transfusion. Fever and documented infection developed in 15 patients. Non-hematologic toxicity was mild.
Conclusion: Topotecan-based combined chemotherapy has significant antitumour activity and acceptable toxicity as salvage therapy for high risk hematologic malignancies.