Horikoshi Yasuo, Kobayashi Ryoji, Endo Mikiya, Watanabe Arata, Kikuta Atsushi, Koike Kazutoshi, Hanada Ryoji, Hosoya Ryota, Ohara Akira, Ikuta Koichiro, Goto Hiroaki, Asami Keiko, Sugita Kanji, Horibe Keizo, Tsurusawa Masahito, Hori Toshinari, Hara Junichi, Nishimura Shinichiro, Nagatoshi Yoshihisa, Mugishima Hideo, Ohta Shigeru, Adachi Souichi, Tsukimoto Ichiro
Division of Hematology and Oncology, Shizuoka Children's Hospital.
Rinsho Ketsueki. 2010 Feb;51(2):104-13.
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.
