The impact of induction anthracycline on long‐term failure‐free survival in childhood acute lymphoblastic leukemia

Abstract

Early intensive therapy might be critical in improving failure-free survival for children with acute lymphoblastic leukemia. Between 1973 and 1977, 107 children received vincristine and prednisone (VP) induction and 30 received the same two agents plus an anthracycline (VPA). Ninety-nine of the VP-treated group and all 30 of the VPA-treated patients achieved complete remission. At a median observation time of 10 years, 59 of 137 children remain in continuous complete remission. Failure-free survival was 37% for the VP group and 63% for the VPA group (p = 0.02). Failure-free survival for boys who received VP was 28%, compared with 68% for boys who received VPA (p = 0.007). All 11 extramedullary relapses and all seven relapses occurring beyond 3.8 years from diagnosis (three testicular and four bone marrow) were observed among the VP group. We conclude that use of an anthracycline during remission induction therapy influenced failure-free survival and that early results of successful antileukemic therapy in children must be confirmed by follow-up progress reports.

Multicentre analysis of anthracycline‐induced cardiotoxicity in children following treatment according to the nephroblastoma studies SIOP No.9/GPOH and SIOP 93‐01/GPOH*

“…Although the dose-response relationship between anthracycline regimens and relapsefree or event-free survival rates is well known [1,2], the clinical application of these agents is limited by the potential hazard of a toxic cardiomyopathy. Today, due to the restriction of cumulative anthracycline dose, early cardiotoxicity is an uncommon complication in children and is usually attenuated by stopping anthracycline therapy [3,4].…”

Effects of caffeic acid on doxorubicin induced cardiotoxicity in rats

“…Doxorubicin (DOX) is one of the most active anthracycline antibiotics that has been used for long time in the therapy of many types of human malignancies [1], [2] either alone or combination with other cytocidal agents [3]. Its clinical uses are limited by seriously high incidence of cardiotoxicity, acute effects can occur immediately after treatment and are characterized by transient arrhythmias, reversible hypotension and pericarditis [4] while, chronic cardiotoxicity can manifest years to decades after treatment.…”

Survival of Childhood Acute Lymphoblastic Leukemia: Results of Therapy at Tata Memorial Hospital, Bombay, India

“…The longest gap between termination of therapy and relapse has been 13 years. The longest period between concluding therapy and relapse in the Norwegian study,5 was 12.3 years while it was 5.3 years in the Italian study: and 3.5 years in a study by Hitchcock et al 7 The single most important factor for predicting the outcome after five years of continued clinical remission was relapse occurring before the fifth year.3.8,9-1* According to Mandelli et al, '3 a child who has remained in complete remission for at least 9 years is likely to be cured.…”