Abstract | BACKGROUND: METHODS: RESULTS: Twenty-eight of 31 patients with circulating blast cells were evaluable for response to topotecan. Twenty-five patients (89.3%) had a response (>25% decrease in circulating blast cells). The leukocyte count (P = .0001) and blast cell count (P = .0009) declined significantly during topotecan therapy. The median (range) topotecan lactone area under the concentration-time curve after the first dose was 85.4 L/hour/m(2) (range, 38.7-229.3 L/hour/m(2)). At the end of induction, 23 patients (74.2%) had a complete response, 1 patient (3.2%) had a partial response, 5 patients (16.1%) had no response, and 2 patients had died of infection. Six of the 17 patients who were studied for minimal residual disease (MRD) achieved MRD-negative status at the end of induction. The main toxicities were hematologic, gastrointestinal, and hepatic. The estimated 5-year survival rate, event-free survival rate, and cumulative incidence of second relapse were 24.1% +/- 7.9%, 18.2% +/- 7.4%, and 22.8% +/- 8.7%, respectively, in the 29 patients who had a hematologic first relapse. CONCLUSIONS: A regimen comprising single-agent topotecan given with a standard 3-drug combination was effective in inducing remission in pediatric patients with relapsed ALL and was tolerated well.
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Authors | Nobuko Hijiya, Clinton F Stewart, Yinmei Zhou, Dario Campana, Elaine Coustan-Smith, Gaston K Rivera, Mary V Relling, Ching-Hon Pui, Amar Gajjar |
Journal | Cancer
(Cancer)
Vol. 112
Issue 9
Pg. 1983-91
(May 01 2008)
ISSN: 0008-543X [Print] United States |
PMID | 18318429
(Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Vincristine
- Topotecan
- Dexamethasone
- Asparaginase
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Topics |
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Asparaginase
(administration & dosage)
- Child
- Child, Preschool
- Dexamethasone
(administration & dosage)
- Female
- Humans
- Infant
- Male
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
(drug therapy, mortality)
- Recurrence
- Topotecan
(administration & dosage, adverse effects, pharmacokinetics, therapeutic use)
- Vincristine
(administration & dosage)
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