EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Novel multiagent chemotherapy for bone marrow relapse of pediatric acute lymphoblastic leukemia



Novel multiagent chemotherapy for bone marrow relapse of pediatric acute lymphoblastic leukemia



Medical & Pediatric Oncology 34(5): 313-318



Background: Despite improvements in the treatment of pediatric acute lymphoblastic leukemia, approximately one in five patients will develop recurrent disease. The majority of these patients do not survive. This limited institution study sought to improve event-free survival (EFS) by intensification of chemotherapy. Procedure: Twenty-one patients with either an isolated marrow (n = 16) or a combined marrow and central nervous system relapse (n = 5) received treatment according to Children's Hospital of Philadelphia protocol CHP-540. Six patients had an initial remission of <36 months, and five patients had relapsed within 1 year of completion of phase III therapy. Induction and reinduction therapy consisted of idarubicin, vincristine, dexamethasone, asparaginase, and triple intrathecal chemotherapy. Consolidation and reconsolidation therapy employed high-dose cytarabine, etoposide, and asparaginase given in a sequential manner. Maintenance therapy included courses of high- or low-dose cytarabine followed by sequential etoposide and asparaginase pulse, moderate-dose methotrexate with delayed leukovorin rescue, and vincristine/dexamethasone pulses. Therapy continued for 2 years from the start of interim maintenance in the 16 patients who did not receive a bone marrow transplant (BMT). Two patients underwent an HLA-identical sibling BMT specified by protocol. Four received a nonprotocol-prescribed alternative donor BMT. Results: The complete remission induction rate was 95%. With a median follow-up from date of relapse of 49 months in survivors, the actuarial EFS based on intent to treat is 75%. There were three toxic deaths in patients in CR and two deaths from relapse. Conclusions: This regimen is toxic but effective and deserves study in a larger setting.

(PDF emailed within 0-6 h: $19.90)

Accession: 011072697

Download citation: RISBibTeXText

PMID: 10797352

DOI: 10.1002/(sici)1096-911x(200005)34:5<313::aid-mpo1>3.0.co;2-q



Related references

Novel multiagent chemotherapy for bone marrow relapse of pediatric acute lympohoblastic leukemia. Blood 92(10 SUPPL 1 PART 1-2): 400A, Nov 15, 1998

Long term outcomes for bone marrow relapse of pediatric acute lymphocytic leukemia using intensive multiagent chemotherapy on CHP-540. Pediatric Research 49(4 Part 2): 207A, April, 2001

Linear growth in children with acute lymphoblastic leukemia all following first marrow relapse treated with chemotherapy or bone marrow transplantation bmt a pediatric oncology group study. Clinical Research 38(4): 947A, 1990

Chemotherapy for bone marrow relapse of childhood acute lymphoblastic leukemia. Cancer ChemoTherapy and Pharmacology 24 Suppl 1: S16-S19, 1989

Non-hematologic relapse after bone marrow transplantation in pediatric acute lymphoblastic leukemia coincident with normal marrow of donor origin. Blood 88(10 SUPPL 1 PART 1-2): 271B, 1996

Effective combination chemotherapy with rituximab for acute lymphoblastic leukemia with bone relapse after bone marrow transplantation. Japanese Journal of Clinical Hematology 49(11): 1556-1561, 2008

Study of reinduction chemotherapy in bone marrow relapse of childhood acute lymphoblastic leukemia. Japanese Journal of Clinical Hematology 30(11): 1923-1930, 1989

Research progress on mechanism of bone marrow relapse in pediatric acute lymphoblastic leukemia. Zhongguo Shi Yan Xue Ye Xue Za Zhi 21(1): 231-235, 2013

Bone marrow relapse in high-risk pediatric patients with acute lymphoblastic leukemia: a comparison of relapse times and initial clinical features of patients on different protocols. Children's Cancer and Leukemia Study group (CCLSG). Japanese Journal of Clinical Hematology 39(8): 565-573, 1998

Toxicity and efficacy of intensive chemotherapy for children with acute lymphoblastic leukemia (ALL) after first bone marrow or extramedullary relapse. Pediatric Blood & Cancer 43(5): 571-579, 2004

A Phase I Study of Clofarabine With Multiagent Chemotherapy in Childhood High Risk Relapse of Acute Lymphoblastic Leukemia (VANDEVOL Study of the French SFCE Acute Leukemia Committee). Pediatric Blood & Cancer 63(2): 270-275, 2016

Extramedullary Gastric Relapse at the Time of Bone Marrow Relapse of Acute Lymphoblastic Leukemia after Allogeneic Bone Marrow Transplantation. Internal Medicine 56(23): 3215-3217, 2017

Aggressive combination chemotherapy of bone marrow relapse in childhood acute lymphoblastic leukemia containing aclacinomycin-A: a multicentric trial. Haematology and Blood Transfusion 30: 493-496, 1987

Intensive retreatment of childhood acute lymphoblastic leukemia in first bone marrow relapse. A Pediatric Oncology Group Study. New England Journal of Medicine 315(5): 273-278, 1986

Reinduction therapy in 297 children with acute lymphoblastic leukemia in first bone marrow relapse: a Pediatric Oncology Group Study. Blood 72(4): 1286-1292, 1988