Navigation Links
Improved chemo regimen for childhood leukemia may offer high survival, no added heart toxicity
Date:5/23/2013

(WASHINGTON, May 23, 2013) Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at a more intense-than-standard dose during initial treatment may result in high survival rates without causing any added heart toxicity, according to the results of a study published online today in Blood, the Journal of the American Society of Hematology (ASH).

Acute myeloid leukemia (AML), the second most common form of leukemia in children, is a blood cancer in which the bone marrow makes a large number of abnormal white blood cells that crowd out other healthy blood cells over time, leading to infection, anemia, or excessive bleeding. Most adults and children with AML receive a first line of treatment (known as induction therapy) soon after diagnosis with a class of chemotherapy drugs called anthracyclines. Standard induction regimens in children typically consist of three days of an anthracycline such as daunorubicin or idarubicin and seven to 10 days of another chemotherapy such as cytarabine. Approximately 60 to 70 percent of children with AML achieve long-term survival with this combination of drugs.

Recent evidence has suggested that increasing the intensity of induction treatment might improve remission rates and perhaps overall survival in AML patients. However, clinicians have used this approach sparingly in pediatric patients because of documented dose-related anthracycline toxicity in children, particularly the significant risk of damage to the developing heart muscle. In an effort to increase the effectiveness of this treatment for children with AML but reduce the cardiac risk profile, researchers are now investigating a liposomal (or lipid-based) formulation of the anthracycline daunorubicin (L-DNR) that allows for more targeted delivery of the drug in the cancerous cells and diffuses at a slower pace in the body which leads to a lower accumulation in the heart. Results from early pre-clinical studies of the lipid-based formulation suggest that L-DNR may be effective at higher-than-standard doses without causing added cardiotoxicity.

"We know that the standard induction treatment regimen is effective in pediatric leukemia patients, but recognize that the toxicities associated with this therapy can be damaging to young patients who are still growing and developing," said lead study author Ursula Creutzig, MD, of the Hannover Medical School in Germany. "This unique formulation of daunorubicin might offer us a way to effectively manage AML in these young patients while reducing their risk of experiencing the acute and long-term toxicities associated with traditional regimens."

To evaluate this hypothesis, Dr. Creutzig and a team of researchers initiated a trial to determine if L-DNR at intensified dosages in child and adolescent patients would improve their outcomes without added treatment-related acute and long-term cardiotoxicity. Between 2004 and 2010, 521 patients under 18 years of age were randomly assigned to treatment with either L-DNR or idarubicin induction therapy. Patients treated with L-DNR received a higher dose (80 mg/m/day/x3) than the equivalent dose of idarubicin (12 mg/m/day/x3) during induction. Both groups also received additional treatment with cytarabine and etoposide. High-risk patients (defined roughly as those who were not in the favorable cytogenetic group) also received supplemental treatment with a chemotherapeutic agent (2-CDA) after the induction period. Additional cycles of maintenance treatment were administered to all participants, excluding those who received a stem cell transplant.

After a five-year observational period, researchers noted similar results in both treatment arms (76% overall survival in the L-DNR group vs. 75% in the idarubicin group). The probability of event-free survival (or pEFS) was also similar in the L-DNR (59%) and idarubicin groups (53%), as were pEFS results for standard risk (72% for L-DNR vs. 68% for idarubin) and high-risk patients (51% vs. 46%, respectively).

Overall, treatment with this intensified induction regimen had a similar safety and tolerability profile to the traditional idarubicin dose. Treatment-related mortality was lower in the L-DNR group than in the idarubicin group (2/257 vs. 10/264 patients), and there were no unusual or persistent toxicities seen when compared with previous related trials. The team observed generally low rates of cardiotoxicities across the treatment groups in the study, though fewer events were reported among the L-DNR treated patients than the idarubicin-treated patients. In the L-DNR group, there were four reports of severe acute cardiotoxicities, such as functional impairment, versus five events in the idarubicin group. There was a single patient reported to have late cardiotoxicity during follow-up in the L-DNR group, as compared with three patients in the idarubicin treatment group.

"These findings signal an important step forward in our goal to identify treatments that can give pediatric patients the best chance for long-term survival with minimal toxic side effects, and we believe the approach could have a number of extended applications. For example, this treatment formulation may be appropriate to use in adults or elderly patients to reduce the toxicity profile, or it may be of value for other malignant diseases in both children and adults," said Dr. Creutzig. "We look forward to further investigating L-DNR as the standard anthracycline induction treatment in future studies."


'/>"/>

Contact: Amanda Szabo
aszabo@hematology.org
202-552-4914
American Society of Hematology
Source:Eurekalert

Related medicine news :

1. Researchers find genetic tie to improved survival time for pulmonary fibrosis
2. Irregular Menses and Pain Caused by Adenomyosis or Endometriosis Can Be Improved with Herbal Therapy without Pain Killers & Surgeries - Wuhan Dr. Lee’s TCM Clinic
3. hCGTreatments / Diet Doc hCG Diets & Weight Loss Offers improved hCG Diets With More Beneficial Nutritional Content, Possibly Offering Relief for Painful Symptoms of IBS
4. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Announces New Improved hCG Diet Helping Patient’s Control Eating Impulses
5. New FDA Proposed Tanning Bed Regulations Push For Improved Warnings During National Skin Cancer Awareness Month
6. hCGTreatments / Diet Doc hCG Diets and Weight Loss Plans Offers a New Solution To Shedding Excess Weight With Improved, Medically Supervised hCG Diet Plans
7. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Offer Improved hCG Diets to Counteract Metabolic Slowdown
8. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Offers Improved hCG Diet Plans Capable of Relieving Migraine Headaches Associated with Carrying Extra Pounds
9. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Offer Newly Improved hCG Diets for Healthy Lifestyle Changes without the Dangerous Risks of Weight Loss Surgery
10. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Targets America’s Teen Obesity Epidemic With Recently Improved hCG Diet Plans
11. hCGTreatments / Diet Doc hCG Diets & Weight Loss Plans Combine Improved Prescription hCG with Lasting Education on How to Lose Weight Safely
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... ... ... Rob Lowe acts as host and helps educate and inform the public using the ... can reconnect with America as it explores some of the best places to hike ... an inventive new place for a family vacation, and have discovered hiking. Many will ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... “THE FLINTHILLS FAMILY-Our Journey to the Cross”: ... FAMILY-Our Journey to the Cross” is the creation of published authors, Bob and Margaret Massey. ... used to say, he is "panther quick and leather tough." His love for others ...
(Date:5/26/2017)... ... May 26, 2017 , ... “Cactus Jack: Against All Odds”: ... many others. “Cactus Jack: Against All Odds” is the creation of published author, ... Hubbard is married to Jack Carlisle’s third child Jane. Walter. Walter and Jane ...
(Date:5/24/2017)... ... May 24, 2017 , ... In modern research, ... most appropriate instruments for research and understanding the basic principles that were designed ... focus on innovations in stereo microscopy for brightfield and fluorescence typically used in ...
(Date:5/24/2017)... San Diego, California (PRWEB) , ... May 24, ... ... patient care through innovative medical image management and interpretation, has received U.S. Food ... technology. , Nucleus.io is a web-based, scalable and secure cloud platform for ...
Breaking Medicine News(10 mins):
(Date:5/10/2017)... , May 10, 2017  The Corporate Whistleblower ... employees of sleep therapy clinics to call us ... therapy clinic is involved in a substantial scheme ... in hearing from an employee of a medical ... a kickback scheme to provide medical practice groups with ...
(Date:5/10/2017)... 10, 2017 CSSi, the global leader in ... research industry, is proud to announce the launch of ... website features both enriched content and a customized layout ... the company,s already well-established position as the top global ... "After many months of hard work, we are delighted ...
(Date:5/9/2017)... 9, 2017  Demonstrating its commitment to representing ... for the Pharmaceutical Research and Manufacturers of America ... companies will now have to meet new research ... eligible to join PhRMA. "By putting ... sending a clear message that being a member ...
Breaking Medicine Technology: