Epirubicin in Childhood Acute Lymphoblastic and Myeloid Leukemia in Relapse

Nineteen children with acute lymphoblastic leukemia (ALL) and 11 with acute non-lymphoblastic leukemia (ANLL) in first or subsequent hematological relapse, and previously exposed to high doses of anthracyclines, were treated with Epirubicin. Eleven patients (7 ANLL and 4 ALL) were treated with Epirubicin as a single drug at the dose of 30 mg/m(2)/day for 3 days a week for 1-3 weeks. 5/7 with ANLL and 0/4 with ALL achieved complete remission (C.R.). Nineteen patients (15 ALL and 4 ANLL) were treated with Epirubicin in combination with Vincristine and Prednisone or Cytosine-arabinoside, Cyclophosphamide and VP-16. 14/15 with ALL and 3/4 with ANLL achieved C.R. One patient previously treated with 750 mg/m(2) of daunornycin developed congestive heart failure (CHF) with a decrease in the cardiac ejection fraction at 11% after receiving 270 mg/m(2) of Epirubicin. No other patients developed CHF. These data are in keeping with the reports in the literature which suggest that Epirubicin is less cardiotoxic than Doxorubicin, while retaining a similar clinical activity.