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Sequential high-dose cytosine arabinoside-asparaginase treatment in advanced childhood leukemia
Insights
High-dose cytosine arabinoside (ara-C) and asparaginase chemotherapy showed promise for advanced leukemia in children. This regimen achieved significant remission rates in acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL) patients.
Area of Science:
- Pediatric Oncology
- Hematology
- Cancer Chemotherapy
Background:
- Leukemia remains a significant health challenge in pediatric populations.
- Advanced leukemia in children requires effective and tolerable treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and toxicity of sequential high-dose cytosine arabinoside (ara-C) and asparaginase in children with advanced leukemia.
- To determine remission rates in acute lymphocytic leukemia (ALL) and acute nonlymphocytic leukemia (ANLL) treated with this regimen.
Main Methods:
- A cohort of 41 children (6 months to 21 years) with advanced leukemia received sequential high-dose ara-C and asparaginase.
- Patients were monitored for complete remission and adverse events, including infection and neurologic toxicity.
Main Results:
- Complete remissions were achieved in 10 of 22 patients with ALL and 8 of 19 patients with ANLL.
- The most frequent toxicity was infection (22 patients). Neurologic toxicity was observed in patients receiving intrathecal chemotherapy within 24 hours of ara-C.
Conclusions:
- The sequential high-dose ara-C and asparaginase regimen demonstrates a high response rate in children with advanced leukemia.
- Further investigation of this regimen in less advanced pediatric ALL and ANLL is warranted.
Abstract:
Sequential high-dose cytosine arabinoside (ara-C) and asparaginase were given to 41 children age six months to 21 years of age with advanced leukemia. Ten of 22 patients with acute lymphocytic leukemia (ALL) and eight of 19 patients with acute nonlymphocytic leukemia (ANLL) obtained complete remissions. The most significant toxicity seen was infection in 22 patients. In addition, patients given intrathecal chemotherapy within 24 hours of ara-C developed neurologic toxicity. The high response rate seen in these patients with advanced leukemia indicates that a trial of this regimen is warranted in children with less advanced ALL and ANLL.