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Effectiveness of high‐dose MCNU therapy and hematopoietic stem cell autografts treatment of childhood acute leukemia/lymphoma with high‐risk features
Author(s) -
Takaue Yoichi,
Watanabe Tsutomu,
Hoshi Yasutaka,
Abe Takanori,
Matsunaga Keiko,
Saito ShinIchi,
Hirao Atsushi,
Kawano Yoshifumi,
Ninomiya Tsuneo,
Kuroda Yasuhiro,
Koyama Tetsuya,
Suzue Takeshi,
Shimokawa Tatsuo,
Uchiyama Hiroshi,
Watanabe Arata,
Matsushita Takeji,
Kikuta Atsushi,
Yokobayashi Ayako,
Murakami Ryusuke,
Manabe Atsushi,
Hosoya Ryota,
Ohira Mutsuro,
Fujimoto Takeo
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910401)67:7<1830::aid-cncr2820670703>3.0.co;2-e
Subject(s) - medicine , total body irradiation , busulfan , etoposide , regimen , cyclophosphamide , toxicity , gastroenterology , surgery , chemotherapy
Clinical and pharmacokinetic studies were performed regarding the toxicity of methyl 6‐[3‐(2‐chloroethyl)‐3‐nitrosoureido]‐6‐deoxy‐α‐D‐glucopyranoside (MCNU) with other drugs, in conjunction with a peripheral blood stem cell autograft (PBSCT), for treating 26 children with acute leukemia or lymphoma associated with high‐risk features. In the early phase of the study, MCNU (300 to 500 mg/m 2 ) was administered with cytosine arabinoside (Ara‐C) (1.6 to 16 g/m 2 ),etoposide (VP‐16) (0.8 to 1.6 g/m 2 ), cyclophosphamide (CY) (100 to 200 mg/kg), or busulfan (16 mg/kg). No acute toxicity was noticed after this high‐dose therapy. The dose‐limiting factor of the regimens was significant but reversible interstitial pneumonitis (IP). In a subsequent trial with an MCNU/VP‐16/Ara‐C/CY (MCVAC) regimen in which the dose of MCNU was reduced, the risk of IP diminished. This study is still in progress, but the clinical response has so far been encouraging. Fifteen of 26 children are alive and well in unmaintained complete remission (CR) with a median follow‐up period of 11 months (range, 3 to 34 months) after transplantation.