Low dose continuous infusion doxorubicin in children and young adults.
Ten patients (age range 3.2-26.3 yrs) with relapsed or resistant malignancies received a total of 20 courses of low dose continuous infusion doxorubicin (3 mg/m2/day for 28 days) delivered by portable Graseby infusion pumps via central venous catheters. Each patient received a median dose of 144 mg/m2 (range 87-261). Four patients responded to treatment (1 complete response (CR) and 3 partial response (PR)) and performance status improved in seven patients. Overall toxicity was minimal: WHO Grade 4 anaemia in 2/18 courses, Grade 4 neutropenia in 1/18, Grade 3-4 thrombocytopenia in 3/18, nausea and vomiting of Grades 2 and 4 in 4/20 and 1/20 respectively, and mucositis of Grades 2 and 4 in 2/20 courses each. Cardiac toxicity was assessed using echocardiography, and fractional shortening remained within normal limits in all patients. Low dose continuous infusion doxorubicin is a feasible, well tolerated, ambulatory therapy in children and may be an effective way of delivering doxorubicin with less toxicity, thus enabling the development of more dose intensive regimens.
Kynaston
J A
JA
Department of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
Pearson
A D
AD
Kernahan
J
J
Lucraft
H
H
Barstow
D
D
Thompson
A
A
Craft
A W
AW
D000293:Adolescent; D000328:Adult; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D007902:Length of Stay; D009447:Neuroblastoma / Q000188:drug therapy*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012074:Remission Induction; D012509:Sarcoma / Q000188:drug therapy*
D004317:Doxorubicin