Abstract
Anthracyclines are among the most useful drugs in the treatment of both lymphoblastic (ALL) and nonlymphoblastic (ANLL) acute leukemias of childhood. However, the benefit of the most commonly used anthracyclines daunorubicin and doxorubicin is limited by their cardiotoxicity [1] and by resistance against these compounds. The daunorubicin analog idarubicin (4-demethoxydaunorubicin) might be less cardiotoxic and has shown greater antileukemic efficacy in some preclinical and clinical trials [2]. In addition, the chemical structure of idarubicin leads to appreciable resorption of active drug after oral application [3, 4], allowing therapy in an outpatient setting. We therefore conducted an open, multicenter trial assessing the toxicity and efficacy of oral idarubicin in refractory acute leukemia in children.
Supported by Farmitalia Carlo Erba GmbH, Freiburg
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Von Hoff DD, Rosencweig M, Piccart M (1980) The cardiotoxicity of anticancer agents. Semin Oncol 9: 23
Carella AM, Berman E, Maraone M, Ganzi-na F (1990) Idarubicin in the treatment of acute leukemias. An overview of preclinical and clinical studies. Haematologica (Pavia) 75: 1–11
Smith DB, Margison JM, Lucas SB, Wilkinson PM, Howell A (1987) Clinical pharmacology of oral and intravenous 4-demethox-ydaunorubicin. Cancer Chemother Pharmacol 19: 138–142
Gillies HC, Herriot D, Liang R, Ohashi K, Rogers HJ, Harper PG (1987) Pharmacokinetics of idarubicin (4-demethoxydaunorubi-cin; IMI-30; NSC 256439) following intravenous and oral administration in patients with advanced cancer. Br J Clin Pharmacol 23: 303–310
Wiernik P (ed) (1989) Idarubicin: a new presence in leukemias. Semin Oncol 16 [Suppl 2]: 1–36
Casazza AM, Pratesi G, Giuliani F, DiMarco A (1980) Antileukemic activity of 4-deme-thoxydaunorubicin in mice. Tumori 66: 549–552
Erttmann R, Bode U, Erb N, Forcadell de Dios P, Gutjahr P, Haas R, Kuhn N, Siewert H, Landbeck G (1988) Antineoplastische Wirksamkeit und Toxizität von Idarubicin (4-Demethoxydaunorubicin) bei rezidivierten akuten Leukämien des Kindesalters. Klin Pädiatr 200: 200–204
Daghestani AN, Arlin ZA, Leyland-Jones B, Gee TS, Kempin SJ, Mertelsmann R, Budman D, Schulman P, Baratz R, Williams L, Clarkson BD, Young CW (1985) Phase I and II clinical and pharmacological study of 4-demethoxydaunorubicin (idarubicin) in adult patients with acute leukemia. Cancer Res 45: 1408–1412
Carella AM, Santini G, Martinengo M, et al. (1985) 4-Demethoxydaunorubicin in refractory or relapsed acute leukemias. A pilot study. Cancer 55 1452–1454
Harrousseau JL, Hurteloup P, Reiffers J, et al. (1987) Idarubicin in the treatment of relapsed or refractory acute myeloid leukemia. Cancer Treat Rep 71: 991–995
Tan CTC, Hancock C, Steinherz P, Bacha DM, Steinherz L, Luks E,Winick N, Meyers P, Mondora A, Dantis E, Niedzwiecki D, Stevens YW (1987) Phase I and clinical pharmacological study of 4-demethoxydau-norubicin (idarubicin) in children with advanced cancer. Cancer Res 47: 2990–2995
Madon E, Grazia G, De Bernardi B, Comelli A, Carli M, Sainati L, Paolucci G, Canino R, Colella R, Bagnulo S, Di Pietro N (1987) Phase II study of idarubicin administered iv to pediatric patients with acute lymphoblastic leukemia. Cancer Treat Rep 71: 855–856
Harris R, Feig S, Baum E, Holcenberg J, Pendergrass T, Bleyer A, Holt C, Krailo M, Hammond D (1988) Idarubicin ( IDR) vs daunomycin for reinduction of relapsed childhood ALL - a CCSG study. Proc Am Soc Clin Oncol 7: 189
Tan C, Bacha D, Hancock C (1984) New anthracyclines in childhood cancer. 14th International Congress of Chemotherapy, (abstr No 104)
Pui CH, de Graaf SS, Dow LW, Rodman JH, Evans WE, Alpert BS, Murphy SB (1988) Phase I clinical trial of orally administered 4-demethoxydaunorubicin (idarubicin) with pharmacokinetic and in vitro drug sensitivity testing in children with refractory leukemia. Cancer Res 48: 5348–5352
Lowenthal RM (1987) A possible special role for oral idarubicin in the treatment of leukemia following myelodysplastic syndrome. In: Mandelli F, Polli E, Clarkson B (eds) Proceedings of the session in idarubicin in the treatment of acute leukemia. 4th International Symposium on Therapy of Acute Leukemia. Excerpta Medica, Amsterdam, pp 50–55
Höchster H, Green M, Liebes L, Speyer JL, Wernz J, Blum R, Muggia F (1990) Good tolerance of weekly oral idarubicin: a phase I study with pharmacology. Cancer Chemother Pharmacol 26: 297–300
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Bielack, S. et al. (1992). Oral Idarubicin in Pretreated Pediatric Acute Leukemia. 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_82
Download citation
DOI: https://doi.org/10.1007/978-3-642-76591-9_82
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-53949-0
Online ISBN: 978-3-642-76591-9
eBook Packages: Springer Book Archive