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

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

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