Erythroleukemia Medication

Author: Beata Holkova, MD; Chief Editor: Emmanuel C Besa, MD more...

Updated: Jul 14, 2011

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Medication Summary
Antineoplastic agents
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Medication Summary

Acute erythroleukemia is treated with the same chemotherapeutic regimens as other acute myelogenous leukemias (AMLs), except the M3 variety (acute promyelocytic leukemia [APL]). Preferably, all patients should be treated in a tertiary referral center.

Class Summary

Antineoplastic agents are used for induction or consolidation therapy. They include cytarabine, daunorubicin, idarubicin, and mitoxantrone.

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Cytarabine

Cytarabine is cell cycle S phase specific. It blocks the progression from G1 to S phase. It is converted intracellularly to the active compound cytarabine-5'-triphosphate, which inhibits DNA polymerase.

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Daunorubicin (Cerubidine)

Daunorubicin is an anthracycline antibiotic. It binds to nucleic acids by intercalation between base pairs of DNA, interfering with DNA synthesis. It causes inhibition of DNA topoisomerase II.

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Idarubicin (Idamycin PFS)

Idarubicin inhibits cell proliferation by inhibiting DNA and RNA polymerase.

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Mitoxantrone (Novantrone)

Idarubicin inhibits cell proliferation by inhibiting DNA and RNA polymerase.

Contributor Information and Disclosures

Author

Beata Holkova, MD Assistant Professor, Massey Cancer Center, Medical College of Virginia, Virginia Commonwealth University School of Medicine

Beata Holkova, MD is a member of the following medical societies: American College of Physicians and American Society of Hematology

Disclosure: Nothing to disclose.

Coauthor(s)

Asher A Chanan-Khan, MD Assistant Professor, Department of Medicine, Division of Lymphoma and Bone Marrow Transplantation, Roswell Park Cancer Institute, State University of New York at Buffalo

Asher A Chanan-Khan, MD is a member of the following medical societies: American College of Physicians, American Medical Association, and American Society of Hematology

Disclosure: Nothing to disclose.

Kenichi Takeshita, MD Adjunct Associate Professor, Department of Medicine, Division of Hematology, New York University School of Medicine; Medical Director, Clinical Research and Development, Celgene

Kenichi Takeshita, MD is a member of the following medical societies: American Society of Hematology

Disclosure: Nothing to disclose.

Specialty Editor Board

David Aboulafia, MD Medical Director, Bailey-Boushay House, Clinical Professor, Department of Medicine, Division of Hematology, Attending Physician, Section of Hematology/Oncology, Virginia Mason Clinic; Investigator, Virginia Mason Community Clinic Oncology Program/SWOG

David Aboulafia, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Medical Directors Association, American Society of Hematology, Infectious Diseases Society of America, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Chief Editor

Emmanuel C Besa, MD Professor, Department of Medicine, Division of Hematologic Malignancies, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University

Emmanuel C Besa, MD is a member of the following medical societies: American Association for Cancer Education, American College of Clinical Pharmacology, American Federation for Medical Research, American Society of Clinical Oncology, American Society of Hematology, and New York Academy of Sciences

Disclosure: Nothing to disclose.

References

Mazzella FM, Alvares C, Kowal-Vern A, Schumacher HR. The acute erythroleukemias. Clin Lab Med. Mar 2000;20(1):119-37. [Medline].
Mazzella FM, Kowal-Vern A, Shrit MA, et al. Effects of multidrug resistance gene expression in acute erythroleukemia. Mod Pathol. Apr 2000;13(4):407-13. [Medline].
Santos FP, Faderl S, Garcia-Manero G, Koller C, Beran M, O'Brien S, et al. Adult acute erythroleukemia: an analysis of 91 patients treated at a single institution. Leukemia. Sep 10 2009;[Medline].
Kowal-Vern A, Mazzella FM, Cotelingam JD, et al. Diagnosis and characterization of acute erythroleukemia subsets by determining the percentages of myeloblasts and proerythroblasts in 69 cases. Am J Hematol. Sep 2000;65(1):5-13. [Medline].
Liu W, Hasserjian RP, Hu Y, Zhang L, Miranda RN, Medeiros LJ, et al. Pure erythroid leukemia: a reassessment of the entity using the 2008 World Health Organization classification. Mod Pathol. Mar 2011;24(3):375-83. [Medline].
Bennett JM, Catovsky D, Daniel MT, et al. Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group. Ann Intern Med. Oct 1985;103(4):620-5. [Medline].
Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4^th ed. Geneva, Switzerland: WHO Press; 2008.
Cuneo A, Van Orshoven A, Michaux JL, et al. Morphologic, immunologic and cytogenetic studies in erythroleukaemia: evidence for multilineage involvement and identification of two distinct cytogenetic-clinicopathological types. Br J Haematol. Jul 1990;75(3):346-54. [Medline].
McHayleh W, Sehgal R, Redner RL, Raptis A, Agha M, Natale J, et al. Mitoxantrone and etoposide in patients with newly diagnosed acute myeloid leukemia with persistent leukemia after a course of therapy with cytarabine and idarubicin. Leuk Lymphoma. Oct 8 2009;[Medline].
Mayer RJ, Davis RB, Schiffer CA, et al. Intensive postremission chemotherapy in adults with acute myeloid leukemia. Cancer and Leukemia Group B. N Engl J Med. Oct 6 1994;331(14):896-903. [Medline].
Wiernik PH, Banks PL, Case DC Jr, et al. Cytarabine plus idarubicin or daunorubicin as induction and consolidation therapy for previously untreated adult patients with acute myeloid leukemia. Blood. Jan 15 1992;79(2):313-9. [Medline].

Bone marrow aspirate showing erythroblasts in a patient with erythroleukemia. Courtesy of Maurice Barcos, MD, PhD, Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY.

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