Total body hyperthermia in combination with etoposide and melphalan in a child with acute myelomonocytic leukemia

Abstract

In vitro and clinical studies have shown antineoplastic effects of hyperthermia alone and in combination with other treatment modalities. Synergistic cytotoxic effects of chemotherapy and hyperthermia have been demonstrated on leukemic cell clones in vitro. It seems that hyperthermia is effective in overcoming chemotherapy resistance. Several groups treated solid tumors by using total body hyperthermia (TBHT). However, only a few studies have been reported investigating the clinical effects of TBHT in myeloproliferative disorders. We report the case of a 7-year-old boy with myelomonocytic leukemia treated with TBHT (2 hours, 42 degrees C) combined with etoposide (600 mg/m2), melphalan (30 mg/m2) and hyperglycemia (200-300 mg/dl). Within 24 hours after TBHT, the leukemic cells decreased after TBHT from 53,000/microliters to zero. Skin leukemic infiltrates, resistant to conventional treatment, also responded well. Although our patient relapsed 34 days after TBHT, these results indicate that TBHT in combination with cytotoxic treatment may be a useful treatment modality in refractory leukemia.

Heat- and 4-hydroperoxy-ifosfamide-induced apoptosis in B cell precursor leukaemias

“…Despite these encouraging results in solid paediatric tumours, regarding paediatric leukaemias there is only one report on a patient with refractory AML (acute myeloid leukemia) in whom remission was achieved by whole body hyperthermia combined with melphalan and etoposide 13 .…”

Whole body hyperthermia in adjuvant therapy of children with renal cell carcinoma

“…In addition, hyperthermia itself kills tumor cells by inducing necrosis and apoptosis 7–9. Only limited experience exists in children using WBH and chemotherapy as a treatment modality in advanced cancer 10–14. In the article we present the results of a pilot study of the application of WBH with doxorubicin and IFN‐α as adjuvant therapy of RCC in children.…”