An in vitro chemosensitivity test for the screening of anti-cancer drugs in childhood leukemia

Article Abstract:

A tissue culture test to evaluate the sensitivity of a patient's cancer cells to chemotherapy may result not only in an improvement in therapy, but an avoidance of therapies which are likely to fail in a particular individual. One such assay involves the ability of living cells to chemically reduce a particular tetrazolium dye, 3-/4,5-dimethylthiazol-2-yl~-2,5-diphenyl tetrazolium bromide, graciously abbreviated MTT. The assay has the advantage of measuring the death of cancer cells photometrically, so that many individual tests may be run and screened automatically with a minimum of labor. Children with leukemia were tested with the MTT assay; 41 samples of peripheral blood cells or bone marrow cells were obtained from 34 patients. Twenty-six different drugs were tested, each in five separate concentrations. The results showed that even among tumors of the same type, such as acute lymphocytic leukemia, there was a significant variation among individuals in the responses to different drugs. When the in vitro assay indicated that the tumor was sensitive to the chemotherapeutic agent, a response was seen in 78.1 percent of the cases. Conversely, a negative response in the assay indicated a negative response in the patient 57.1 percent of the time. The information obtained in the assay was used to guide the choice of treatment in 11 relapses; 9 patients (82 percent) achieved complete or partial remission. Of 15 relapses treated without regard to results of the assay, 6 (40 percent) achieved complete or partial remission. Although it would seem that the use of the MTT assay data provides important therapeutic information, the small numbers of patients used in the study renders the difference not statistically significant. Further use of the MTT assay to guide the selection of chemotherapeutic agents may determine the true clinical value of the assay. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Case studies, Evaluation, Drug therapy, Antineoplastic agents, Leukemia, Tissue culture

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Continuous infusion mitoxantrone in relapsed acute nonlymphocytic leukemia

Article Abstract:

Mitoxantrone is similar in molecular structure to the chemotherapeutic agent doxorubicin, but may have fewer toxic side effects on the heart. In a previous study, individual doses were used and some evidence indicated that the patients who developed high blood levels of mitoxantrone were also those with superior responses. The potential effectiveness of continuous infusion of mitoxantrone, compared with discrete injections, was evaluated in nine patients with acute nonlymphocytic leukemia (ANLL) and two patients with chronic myelogenous leukemia. Three patients died from the treatment; one had hemorrhagic cystitis, one had severe liver failure, and one died from infections stemming from the suppression of bone marrow production. Examination of the bone marrow revealed a greater than 90 percent clearance of leukemic cells in all cases. Four of the patients achieved complete remission. The results suggest that the continuous infusion of mitoxantrone is effective, but that further research is necessary to determine the optimal therapeutic schedule and to minimize toxic side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Methods, Acute leukemia, Nonlymphoid leukemia, Myeloid leukemia, Mitoxantrone hydrochloride, Mitoxantrone

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