[Effectiveness of remission induction with high-dose cytarabine for relapsed or refractory pediatric acute leukemia].
We conducted a multicenter postmarketing study to investigate the efficacy and safety of reinduction therapy with a high-dose cytarabine-containing regimen for pediatric patients with relapsed or refractory acute leukemia. Seven of 13 patients (53.8%) with ALL achieved complete or partial remission, and only 1 of 6 patients (16.7%) with AML achieved partial remission. The frequent non-hematologic adverse events were gastrointestinal toxicities, such as vomiting, diarrhea and abdominal pain, as well as pyrexia and headache. Infection appeared in 9 of 20 (45%) patients. There were two death during reinduction therapy. One died of invasive bronchopulmonary aspergillosis, and the other died of intracranial hemorrhage and renal failure. These results indicated that a high-dose cytarabine regimen is effective as reinduction therapy in pediatric patients with relapsed ALL, and supportive care is essential to prevent or control treatment-related adverse events, such as infection.
Horikoshi
Yasuo
Y
Division of Hematology and Oncology, Shizuoka Children's Hospital.
Kobayashi
Ryoji
R
Endo
Mikiya
M
Watanabe
Arata
A
Kikuta
Atsushi
A
Koike
Kazutoshi
K
Hanada
Ryoji
R
Hosoya
Ryota
R
Ohara
Akira
A
Ikuta
Koichiro
K
Goto
Hiroaki
H
Asami
Keiko
K
Sugita
Kanji
K
Horibe
Keizo
K
Tsurusawa
Masahito
M
Hori
Toshinari
T
Hara
Junichi
J
Nishimura
Shinichiro
S
Nagatoshi
Yoshihisa
Y
Mugishima
Hideo
H
Ohta
Shigeru
S
Adachi
Souichi
S
Tsukimoto
Ichiro
I
D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D055744:Invasive Pulmonary Aspergillosis / Q000209:etiology / Q000517:prevention & control; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D020551:Pulse Therapy, Drug; D012008:Recurrence; D012074:Remission Induction; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine