Hepatocellular toxicity during the treatment of refractory acute leukemia with indicine N‐oxide

Abstract

Indicine N‐oxide is the first member of the large class of compounds comprised of pyrrolizidine alkaloids and their N‐oxides to be studied in the treatment of cancer in humans. Twenty‐two patients with refractory acute leukemia received indicine N‐oxide daily for 5 consecutive days in a dose‐seeking study. Of eight patients with refractory acute lymphocytic leukemia, one had a complete remission, and one had a partial remission. Of 11 patients with refractory acute nonlymphocytic leukemia, 2 patients had complete remissions. Of three patients with blast crisis of chronic granulocytic leukemia, one patient had a partial remission. Five patients had severe hepatic toxicity, probably due to venoocclusive disease induced by the drug. Whether hepatotoxicity and antileukemic activity are a result of the same mechanism of action of indicine N‐oxide is not known. Copyright © 1984 American Cancer Society