title: 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.
authors.affiliation: Department of Pediatrics, School of Medicine, Fukuoka University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nibu
authors.forename: F
authors.initials: F
authors.lastname: Yanai
authors.forename: J
authors.initials: J
authors.lastname: Okamura
authors.forename: Y
authors.initials: Y
authors.lastname: Ikuno
authors.forename: H
authors.initials: H
authors.lastname: Tasaka
authors.forename: A
authors.initials: A
authors.lastname: Matsuzaki
authors.forename: H
authors.initials: H
authors.lastname: Inada
authors.forename: H
authors.initials: H
authors.lastname: Eguchi
authors.forename: R
authors.initials: R
authors.lastname: Sakai
authors.forename: H
authors.initials: H
authors.lastname: Koga
mesh_terms: D015250:Aclarubicin / Q000009:adverse effects / Q000627:therapeutic use*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003630:Daunorubicin / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D016879:Salvage Therapy
chemical_list: D015250:Aclarubicin; D003630:Daunorubicin