Induction Chemotherapy with N(4)-behenoyl-1-beta-D-arabinofuranosylcytosine, Idarubicin and 6-Thioguanine in Childhood Acute Myelogenous Leukemia.
- Author:
Pil Sang JANG
1
;
Keon Hee YOO
;
Jung Youn HONG
;
Hee Young SHIN
;
Hyo Seop AHN
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
BH-AC;
Idarubicin;
Induction chemotherapy;
Remission rate;
Survival;
AML;
Childhood
- MeSH:
Bone Marrow;
Child;
Classification;
Diagnosis;
Diarrhea;
Disease-Free Survival;
Female;
Fever;
Humans;
Idarubicin*;
Induction Chemotherapy*;
Leukemia, Myeloid, Acute*;
Lost to Follow-Up;
Mucositis;
Nausea;
Neutropenia;
Retrospective Studies;
Shock, Septic;
Thioguanine*;
Vomiting
- From:Korean Journal of Pediatric Hematology-Oncology
2000;7(1):72-81
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Retrospective study was performed to evaluate the survivals, remission rate and complications of induction chemotherapy using N(4)-behenoyl-1-beta-D-arabinofuranosylcytosine (BH-AC), idarubicin and 6-thioguanine (6-TG) in newly diagnosed childhood acute myelogenous leukemia. METHODS: From July 1994 to March 2000, 40 children (male 30, female 10) were enrolled in the study. From day 0 to 6 of induction, BH-AC 300 mg/m(2)/day was administered intravenously over 3 hours and from day 7 to 9, dosage was adjusted according to residual leukemic blasts in day 7 bone marrow aspirates. Idarubicin 10 mg/m(2)/day was administered intravenously over 15 minutes from day 0 to 2 and 6-TG 100 mg/m(2)/ day orally divided in two from day 0 to 6. Median age at diagnosis was 4.4 years (1 month~14.9 years) with a distribution according to the FAB classification of 1 M1, 10 M2, 13 M4, 5 M4E, 7 M5a, 3 M6 and 1 M7. RESULTS: Complete remission (CR) rate was 82.5% (33/40) with one cycle of induction chemotherapy and 90.0% (36/40) with additional cycle (BH-AC and idarubicin). One patient achieved partial remission with one cycle and was lost to follow-up, and 3 died of septic shock with disseminated intravascular coagulopathy during induction. Median time to CR from diagnosis was 28 days (25~68) and recovery from neutropenia (ANC> 1,000/muL) was achieved on median day 24 (21~44). All 40 patients had a fever during neutropenic period. Toxicities such as diarrhea, mucositis, nausea and vomiting were observed over half of the patients but tolerable and transient. Five-year overall, relapse- free and event-free survivals were 54.0%, 51.1% and 46.7%, respectively. CONCLUSION: These data show that this regimen is superior to others with high remission rate and well tolerated.
