Mec (mitoxantrone, etoposide, and cytarabine) induces complete remission and is an effective bridge to transplantat in acute myeloid leukemia

INTRODUCTION: Clinical response and chemo-sensitivity of relapse or refractory AML patients were evaluated after rescue and bridge-to-transplant MEC regimen. METHODS AND PATIENTS: consecutive AML patients were treated with MEC from 2009 to 2018. Chemo-sensitivity was evaluated by WT1 quantification. RESULTS: 27/55 patients (49.1%) had AML resistant to induction and 28/55 patients (50.9%) had AML relapse. 25/55 patients (45.5%) achieved a CR after one course of MEC; 12 patients (21.8%) achieved WT1 negativity. In 12 patients, a second MEC was administered. 4 out of 12 patients improved significantly their response with the 2(nd) MEC. MEC was an effective bridge to transplant, 32/55 patients (58.2%), received an allogenic stem cell transplant. Median overall survival (OS) from MEC was 455 days (95% C.I. 307-602 days.); Patient with WT1 negative CR had the best OS (p<.000) CONCLUSION: WT1 is a useful marker of chemo-sensitivity after MEC as rescue and bridge-to-transplant therapy.