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An effective salvage regimen with aclarubicin for daunorubicin-resistant acute non-lymphocytic leukemia in children.

Abstract
We evaluated the efficacy and toxicity of aclarubicin for acute non-lymphocytic leukemia (ANLL) refractory to daunorubicin in childhood. Twenty-four patients were treated with aclarubicin and prednisolone with or without 6-mercaptopurine and behenoyl-cytosine arabinoside daily for 5 to 14 days. Of 21 evaluable patients, 14 (67%) responded: 12 obtained complete remission and 2 partial remission. The median time to reach complete remission was 37 days (range, 16 to 60 days), and the median duration of complete remission was 5.5 months (range, 2 to 41 months). The cumulative dose of anthracycline administered before the study was not considered significant for the response. The only major complication was severe bone marrow suppression; infectious episodes occurred in 14 patients (58%) and three died of sepsis and/or bleeding. The observed non-hematologic toxicities included hematuria, an elevation of serum amylase, nausea/vomiting, and angitis. In addition, one patient showed abnormal cardiac function. Aclarubicin is therefore considered a highly active drug for remission reinduction of previously treated children suffering from ANLL with an acceptable toxicity.
AuthorsK Nibu, F Yanai, J Okamura, Y Ikuno, H Tasaka, A Matsuzaki, H Inada, H Eguchi, R Sakai, H Koga
JournalPediatric hematology and oncology (Pediatr Hematol Oncol) 1995 May-Jun Vol. 12 Issue 3 Pg. 251-8 ISSN: 0888-0018 [Print] England
PMID7640178 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Aclarubicin
  • Daunorubicin
Topics
  • Aclarubicin (adverse effects, therapeutic use)
  • Adolescent
  • Child
  • Child, Preschool
  • Daunorubicin (therapeutic use)
  • Drug Resistance
  • Female
  • Humans
  • Leukemia, Myeloid, Acute (drug therapy)
  • Male
  • Salvage Therapy

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