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Therapy of Relapsed Acute Myeloid Leukemia Using Targeted Plasma Concentrations of Cytosine Arabinoside and Etoposide

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Acute Leukemias

Part of the book series: Haematology and Blood Transfusion / Hämatologie und Bluttransfusion ((HAEMATOLOGY,volume 34))

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Abstract

While the outcome for children with acute lymphocytic leukemia (ALL) has improved as a result of increased dose intensity, the same improvement has not occurred in acute myeloid leukemia (AML). Although approximately 85% of children with AML achieve a complete remission (CR), the majority ultimately relapse and die of their disease [1–5]. Although bone marrow transplant (BMT) offers better disease control, patient selection and the timing of transplantation remains controversial [6–8]. Furthermore, because of the risk of early death and the development of graftversus-host disease, clinical trials have not clearly demonstrated that BMT is the treatment of choice for AML in the first CR [9].

Supported in part by USPHS grant CA-20180, NIH Cancer Center CORE Grant CA-21765, and by the American Lebanese Syrian Associated Charities (ALSAC).

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References

  1. Weinstein HJ, Mayer RJ, Rosenthal DS et al. (1983) Chemotherapy for acute myeloge- 12. nous leukemia in children and adults: VAPA update. Blood 62: 315–319

    PubMed  CAS  Google Scholar 

  2. Buckley JD, Lampkin BC, Nesbit ME et al. (1989) Remission induction in children with acute non-lymphocytic leukemia using cytosine arabinoside and doxorubicin or daunorubicin: a report from the Childrens Cancer Study Group. Med Pediatr Oncol 17: 382–390

    Article  PubMed  CAS  Google Scholar 

  3. Steuber CP, Civin C, Krischer J et al. (1991) A comparison of induction and maintenance therapy for acute nonlymphocytic leukemia in childhood: results of a Pediatric Oncology Group study. J Clin Oncol 9: 247–258

    PubMed  CAS  Google Scholar 

  4. Creutzig U, Ritter J, Riehm H et al. (1985) Improved treatment results in childhood acute myelogenous leukemia: a report of the German Cooperative Study AML-BFM-78. Blood 65: 298–304

    PubMed  CAS  Google Scholar 

  5. Kalwinsky D, Mirro J, Schell M et al. (1988) Early intensification of chemotherapy for childhood acute nonlymphoblastic leukemia: improved remission induction with a five-drug regimen including etoposide. J Clin Oncol 6: 1134–1143

    PubMed  CAS  Google Scholar 

  6. Raimondi SC, Kalwinsky DK, Hayashi Yet al. (1989) The cytogenetics of childhood acute nonlymphocytic leukemia. Cancer Genet Cytogenet 40: 13–27

    Article  PubMed  CAS  Google Scholar 

  7. Kalwinsky DK, Raimondi S, Schell MJ et al. (1990) Prognostic importance of cytogenetic subgroups in de novo pediatric acute nonlymphocytic leukemia. J Clin Oncol 8: 75–83

    PubMed  CAS  Google Scholar 

  8. Grier HE, Gelber RD, Camitta BM et al. (1987) Prognostic factors in childhood acute myelogenous leukemia. J Clin Oncol 5: 1026–1032

    PubMed  CAS  Google Scholar 

  9. Dahl GV, Kalwinsky DK, Mirro J et al. (1990) Allogeneic bone marrow transplantation in a program of intensive sequential chemotherapy for children and young adults with acute nonlymphocytic leukemia in first remission. J Clin Oncol 8: 295–303

    PubMed  CAS  Google Scholar 

  10. Liliemark JO, Plunkett W, Dixon DO (1985) Relationship of 1–3-D-arabinofuranosylcytosine in plasma to 1–3-D-arabinofuranosylcytosine 5’-triphosphate levels in leukemic cells during treatment with high-dose 113-D-arabinofuranosylcytosine. Cancer Res 45: 5952–5957

    PubMed  CAS  Google Scholar 

  11. Rustum YM, Lawrence DD, Priore RL et al. (1986) Relationship between plasma pharmacokinetic parameters of arabinosylcytosine ( ARAC) intracellular ARA-CTP, and toxicity of acute nonlymphocytic leukemia patients to treatment with high dose ARAC. Am Soc Clin Oncol 5: 164–171

    Google Scholar 

  12. Bertino JR (1987) Blood levels of chemotherapeutic agents and clinical outcome. J Clin Oncol 5: 996–997

    PubMed  CAS  Google Scholar 

  13. Rodman JR, Abromowitch M, Sinkule JA et al. (1987) Clinical pharmacodynamics of continuous infusion teniposide: systemic exposure as a determinant of response in a Phase I trial. J Clin Oncol 5: 1007–1014

    PubMed  CAS  Google Scholar 

  14. Preisler HD, Rustum YM, Azarnia N et al. (1987) Abrogation of the prognostic significance of low leukemic cell retention of cytosine arabinoside triphosphate by intensification of therapy and by alteration in the dose and schedule of administration of cytosine arabinoside. Cancer Chemother Pharmacol 19: 69–74

    Article  PubMed  CAS  Google Scholar 

  15. Plunkett W, Iacoboni S, Estey E et al. (1985) Pharmacologically directed ara-C therapy for refractory leukemia. Semin Oncol 3: 20–30

    Google Scholar 

  16. Karp JE, Donehower RC, Dole GB et al. (1987) Correlation of drug-perturbed marrow cell growth kinetics and intracellular 1–13-D-arabinofuranosylcytosine metabolism with clinical response in adult acute myelogenous leukemia. Blood 69: 1134–1140

    PubMed  CAS  Google Scholar 

  17. Hande KR, Wedlund PJ, Noone RM et al. (1984) Pharmacokinetics of high-dose etoposide (VP-16–213) administered to cancer patients. Cancer Res 44: 379–382

    PubMed  CAS  Google Scholar 

  18. Ehninger G, Proksch B, Wanner T et al. (1990) Cytosine arabinoside uptake and cytosine arabinoside triphosphate formation by leukemic blast cells is inhibited by etoposide and teniposide. Blood 76 (10) [Suppl 1]: 266 a

    Google Scholar 

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© 1992 Springer-Verlag Berlin Heidelberg

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Mirro, J., Crom, W., Belt, J., Schell, M. (1992). Therapy of Relapsed Acute Myeloid Leukemia Using Targeted Plasma Concentrations of Cytosine Arabinoside and Etoposide. In: Hiddemann, W., Büchner, T., Wörmann, B., Plunkett, W., Keating, M., Andreeff, M. (eds) Acute Leukemias. Haematology and Blood Transfusion / Hämatologie und Bluttransfusion, vol 34. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76591-9_45

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  • DOI: https://doi.org/10.1007/978-3-642-76591-9_45

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-53949-0

  • Online ISBN: 978-3-642-76591-9

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