Journal of Clinical Oncology, Vol 3, 617-621, Copyright © 1985 by American Society of Clinical Oncology
Homoharringtonine: an effective new drug for remission induction in refractory nonlymphoblastic leukemia
RP Warrell Jr, CJ Coonley and TS Gee
Homoharringtonine (HHT) is a new plant alkaloid originally isolated in the
People's Republic of China. Preliminary studies have suggested antitumor
activity in several neoplastic diseases. We treated 49 patients with
relapsed or resistant acute leukemia with escalating doses of
homoharringtonine administered by continuous infusion. Three dose levels
were examined: 5 mg/m2 for seven days, 7 mg/m2 for seven days, and 5 mg/m2
for nine days. Of 28 patients with acute nonlymphoblastic leukemia who
received cumulative doses of 45 to 49 mg/m2, seven patients (25%) achieved
complete remission. Four of these remissions occurred in a subset of ten
patients previously resistant to two or more induction attempts with
conventional chemotherapy. There were no remissions in three patients with
secondary leukemia or in seven patients with acute lymphoblastic leukemia.
Reversible hypotension, fluid retention, diarrhea, and tumor lysis syndrome
were the major toxic effects of this treatment. Our results indicate that
homoharringtonine is an effective new drug for the treatment of acute
nonlymphoblastic leukemia and that this drug does not share cross-
resistance with conventional antileukemic agents. The recommended dose is 5
mg/m2/d administered by continuous infusion for nine days.
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