Mitoxantrone, Cytosine Arabinoside and VP-16 (MAV) for De Novo Acute Myeloid Leukemia: A Pilot Study

In several studies it could be shown that mitoxantrone has considerable antileukemic activity [1–3]. In a previous report we showed that the combination of mitoxantrone with cytosine arabinoside and VP-16 is effective in relapsed and refractory acute myeloblastic leukemia (AML) [4]: 21 (58.3%) of 36 patients achieved a complete hematological remission with a therapy consisting of mitoxantrone (M) 10 mg/m2 i. v., cytosine arabinoside (A) 100 mg/m2 continuous infusion and VP-16 (V) 100 mg/m2 i. v., each for 5 days (MAV protocol). Encouraged by the high antileukemic activity and moderate toxicity, we applied this triple combination in elderly patients with untreated AML. The question was whether the effectiveness of MAV therapy could lead to a high response rate in this group of patients with intermediate risk.