Sertraline and Cytosine Arabinoside in Adults With Relapsed and Refractory AML

Relapsed and refractory acute myeloid leukemias are characterized by net drug resistance. At the root of this drug resistance is an enhanced survival that relates to intrinsic cell cycle dysregulation and aberrations in the overall process of the repair of DNA damage. These malignancies represent a continuing therapeutic challenge, since currently no "standard treatments" for these diseases exist. Approximately 30% of adults with newly diagnosed AML are primary refractory to chemotherapy and at least 50% of those who achieve remission will relapse. For patients with relapsed or refractory AML, the expected CR/CRi rates with traditional multi-agent chemotherapies range from \< 10% for primary refractory AML to 25-30% for relapsed AML and cure rates \< 20%, even with allogeneic stem cell transplantation. Thus, novel treatment approaches are needed.