"Above all do no harm:" horizons in pediatric oncology.
The articles selected in this review highlight some advances in the use of the "old standards" methotrexate and 6-mercaptopurine for the treatment of children with acute lymphoblastic leukemia, especially the laboratory studies, which may allow a "pharmacologic phenotyping" to identify children most likely to relapse. In addition, we review the use of "newer" drugs (epipodophyllotoxins), which may be effective but are also associated with high morbidity (ie, secondary acute myeloid leukemia). As a second issue, "dose intensity" and the use of high-dose chemotherapy followed by bone marrow transplantation will be challenged, especially in light of peripheral stem cell harvest and the use of growth factors.
Weitman
S D
SD
Department of Pediatrics, University of Texas Southwestern Medical Center Dallas 75235.
Winick
N J
NJ
Kamen
B A
BA
D016026:Bone Marrow Transplantation; D002648:Child; D003131:Combined Modality Therapy; D006133:Growth Substances / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000139:chemically induced; D008495:Medical Oncology; D015122:Mercaptopurine / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D010372:Pediatrics; D010641:Phenotype; D011034:Podophyllotoxin / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D012008:Recurrence; D015996:Survival Rate
D006133:Growth Substances; D015122:Mercaptopurine; D011034:Podophyllotoxin; D008727:Methotrexate