Outcome of treatment in children with Philadelphia chromosome-positive acute lymphoblastic leukemia

Article Abstract:

Some children with Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) may have a better-than-normal prognosis. The Philadelphia chromosome is an abnormal chromosome that occurs in some leukemia patients. The presence of this chromosome usually indicates a poor prognosis. In a study of 267 ALL patients with the Philadelphia chromosome who went into remission after chemotherapy, 95 had a relatively good prognosis, 92 had an intermediate prognosis, and 80 had the worst prognosis. Bone marrow transplants from a matched donor improved the prognosis over chemotherapy alone. This was true in all three groups.

Health aspects, Prognosis, Philadelphia chromosome

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Acute myeloid leukemia in children treated with epipodophyllotoxins for acute lymphoblastic leukemia

Article Abstract:

Podophyllotoxin is a toxic compound occurring naturally in a plant called Podophyllum peltatum, which is also commonly referred to as the May apple plant or mandrake root. Derivatives of this substance, the epipodophyllotoxins, have found application in the treatment of cancer. These compounds, which include etoposide and teniposide, work by inhibiting the natural repair of DNA within cells. Cancer cells may be destroyed by the accumulation of unrepaired DNA damage. However, it is clear that this same DNA damage may cause a secondary malignancy. Research has already established that epipodophyllotoxins increase the likelihood of secondary acute myeloid leukemia (AML) following treatment for primary cancer. Epipodophyllotoxins are also clastogenic agents, which means they can induce breaks in chromosomes. Many of the secondary leukemias resulting from epipodophyllotoxin treatment have breaks in chromosome 11, more specifically near 11q23. Assessing the cases of 734 children with acute lymphoblastic leukemia who were treated with epipodophyllotoxins, clinical investigators have established which treatment regimens are most likely to cause secondary AML. Secondary AML developed in 21 of the 734 cases. In contrast with secondary cancers caused by alkylating agents (a different class of anticancer drugs), the secondary AML tends to develop rapidly, within six years following epipodophyllotoxin treatment. The risk of AML was found to be related to the frequency of treatment during the chemotherapeutic regimen for the primary leukemia. Overall, the risk of developing AML within six years was 3.8 percent. Patients who received treatment weekly or twice a week had a risk of 12.3 percent. Conversely, for patients not treated with epipodophyllotoxins, treated only during remission induction, or treated every two weeks, the risk was 1.6 percent. The schedule of treatment appears to have the greatest influence on the risk of subsequent AML. The type of primary acute lymphoblastic leukemia, the use of radiotherapy, or the cumulative dose of epipodophyllotoxin appear to be of little consequence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Acute leukemia, Nonlymphoid leukemia, Myeloid leukemia, Etoposide, Myelocytic leukemia

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Human granulocyte colony-stimulating factor after induction chemotherapy in children with acute lymphoblastic leukemia

Article Abstract:

Granulocyte colony-stimulating factor (G-CSF) may reduce the incidence of infection in children with neutropenia but it appears to have few other benefits. Neutropenia is a drop in white blood cells called neutrophils often caused by chemotherapy. Researchers gave daily injections of G-CSF or placebo to 148 children with chemotherapy-induced neutropenia. Children receiving G-CSF had a lower rate of infections, but G-CSF did not reduce hospitalization rates, prolong survival or reduce medical care costs.

Evaluation, Drug therapy, Granulocyte colony-stimulating factor, Neutropenia

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