Therapy of the Newly Diagnosed Adult with Acute Lymphoblastic Leukemia

Daunorubicin continuous infusion induces more toxicity than bolus infusion in acute lymphoblastic leukemia induction regimen: a randomized study

“…During the induction treatment, DNR (60 mg/m 2 /day on days 2 to 4) was delivered according to the initial randomization, either by CI or by rapid 30-minute infusion (i.v.). DNR was given with vincristine (2 mg administered intravenously on days 1,8,15) and oral prednisone (60 mg/m 2 on days 1 to 15). Supportive care was performed according to each center policy.…”

“…However, the toxicity of these induction regimens is high, with 10% to 20% mortality rate during induction as a result of infections, and does not preclude a high relapse rate, leading to 20-40% 5-year disease-free survival, depending in part on patient selection. [1][2][3] Continuous infusion (CI) of cancer chemotherapeutic agents may have enhanced therapeutic effects because of an improved pharmacological availability while the reduced peak plasma concentration level seems to reduce some of their side-effects. 4,5 Studies with solid tumors have shown that anthracycline continuous intravenous infusion could reduce its dose-limiting cardiotoxicity.…”

Hemopoietic Growth and Inhibitory Factors in Treatment of Malignancies: A review

“…It has been suggested that BMT should be limited only to patients with chemosensitive disease in first remission, but there are obvious problems with this approach; because of costs and toxicity, BMT has been used primarily when standard therapies are unikely to produce durable remissions. If conventional therapies improve (by new drugs or new strategies) it will be difficult to justify BMT (62). PBSC as an alternative source of hematopoietic progenitor cells may be used in conjunction with, or instead of, BMT to support the delivery of intensive chemotherapy (63).…”

A phase I trial of a single high dose of idarubicin combined with high-dose cytarabine as induction therapy in relapsed or refractory adult patients with acute lymphoblastic leukemia

“…[1][2][3][4][5][6][7][8][9][10][11] There is a significant relapse rate, however, and only 20-30% of all patients will be cured of their disease. [1][2][3][4][5][6][7][8][9][10][11] Therefore the majority of adults with ALL will require therapy for relapsed or refractory disease.…”