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1. Inaba H, Stewart CF, Crews KR, Yang S, Pounds S, Pui CH, Rubnitz JE, Razzouk BI, Ribeiro RC: Combination of cladribine plus topotecan for recurrent or refractory pediatric acute myeloid leukemia. Cancer; 2010 Jan 1;116(1):98-105
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  • [Title] Combination of cladribine plus topotecan for recurrent or refractory pediatric acute myeloid leukemia.
  • BACKGROUND: The prognosis after recurrence of pediatric acute myeloid leukemia (AML) is poor, and effective salvage regimens are urgently needed.
  • METHODS: In phase 1 and pilot studies, the authors evaluated the maximum tolerated dose (MTD) and dose-limiting toxicities (DLTs) of a 5-day course of cladribine followed by topotecan in pediatric patients with recurrent/refractory AML.
  • Nine (34.6%) of 26 patients experienced a complete response, and 7 (30.4%) achieved a partial response; 5 (19.2%) were long-term survivors at the time of last follow-up.
  • This regimen offers a postrecurrence treatment alternative for patients, especially those who have received anthracycline-containing chemotherapy.

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  • [Copyright] Copyright 2010 American Cancer Society.
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  • (PMID = 19885837.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765; None / None / / P30 CA021765-31; United States / NCI NIH HHS / CA / CA 21765; United States / NCI NIH HHS / CA / P30 CA021765-31
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 47M74X9YT5 / Cladribine; 7M7YKX2N15 / Topotecan
  • [Other-IDs] NLM/ NIHMS151111; NLM/ PMC2920745
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2. Goyal M, Bangert BA, Wiznitzer M: Mesial temporal sclerosis in acute childhood leukemias. Epilepsia; 2003 Jan;44(1):131-4
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  • [Title] Mesial temporal sclerosis in acute childhood leukemias.
  • PURPOSE: Although seizures are relatively common in acute childhood leukemias, evolution into epilepsy is rare.
  • METHODS: We describe three patients with acute leukemias who received chemotherapy.
  • RESULTS: All three developed recurrent complex partial seizures after initiation of chemotherapy.
  • CONCLUSIONS: The association of mesial temporal sclerosis in acute childhood leukemias has not been previously described and may be secondary to antileukemic treatment and recurrent seizures.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Epilepsy, Complex Partial / chemically induced. Leukemia, Myeloid, Acute / drug therapy. Magnetic Resonance Imaging. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Temporal Lobe / drug effects

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  • (PMID = 12581241.001).
  • [ISSN] 0013-9580
  • [Journal-full-title] Epilepsia
  • [ISO-abbreviation] Epilepsia
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. Hijiya N, Ness KK, Ribeiro RC, Hudson MM: Acute leukemia as a secondary malignancy in children and adolescents: current findings and issues. Cancer; 2009 Jan 1;115(1):23-35
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  • [Title] Acute leukemia as a secondary malignancy in children and adolescents: current findings and issues.
  • Secondary acute leukemia is a devastating complication in children and adolescents who have been treated for cancer.
  • Secondary acute lymphoblastic leukemia (s-ALL) was rarely reported previously but can be distinguished today from recurrent primary ALL by comparison of immunoglobulin and T-cell receptor rearrangement.
  • Secondary acute myeloid leukemia (s-AML) is much more common, and some cases actually may be second primary cancers.
  • Treatment-related and host-related characteristics and their interactions have been identified as risk factors for s-AML.
  • The most widely recognized treatment-related risk factors are alkylating agents and topoisomerase II inhibitors (epipodophyllotoxins and anthracyclines).
  • The magnitude of the risk associated with these factors depends on several variables, including the administration schedule, concomitant medications, and host factors.
  • A high cumulative dose of alkylating agents is well known to predispose to s-AML.
  • The prevalence of alkylator-associated s-AML has diminished among pediatric oncology patients with the reduction of cumulative alkylator dose and limited use of the more leukemogenic alkylators.
  • The best-documented topoisomerase II inhibitor-associated s-AML is s-AML associated with epipodophyllotoxins.
  • The risk of s-AML in these cases is influenced by the schedule of drug administration and by interaction with other antineoplastic agents but is not consistently found to be related to cumulative dose.
  • The unpredictable risk of s-AML after epipodophyllotoxin therapy may discourage the use of these agents, even in patients at a high risk of disease recurrence, although the benefit of recurrence prevention may outweigh the risk of s-AML.
  • Studies in survivors of adult cancers suggest that, contrary to previous beliefs, the outcome of s-AML is not necessarily worse than that of de novo AML when adjusted for cytogenetic features.
  • More studies are needed to confirm this finding in the pediatric patient population.

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  • [Copyright] Copyright (c) 2008 American Cancer Society.
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  • (PMID = 19072983.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA021765; None / None / / P30 CA021765-31; United States / NCI NIH HHS / CA / P30 CA021765-31
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] L36H50F353 / Podophyllotoxin
  • [Number-of-references] 99
  • [Other-IDs] NLM/ NIHMS135594; NLM/ PMC2767267
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4. Dahl GV, Lacayo NJ, Brophy N, Dunussi-Joannopoulos K, Weinstein HJ, Chang M, Sikic BI, Arceci RJ: Mitoxantrone, etoposide, and cyclosporine therapy in pediatric patients with recurrent or refractory acute myeloid leukemia. J Clin Oncol; 2000 May;18(9):1867-75
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  • [Title] Mitoxantrone, etoposide, and cyclosporine therapy in pediatric patients with recurrent or refractory acute myeloid leukemia.
  • PURPOSE: To determine the remission rate and toxicity of mitoxantrone, etoposide, and cyclosporine (MEC) therapy, multidrug resistance-1 (MDR1) status, and steady-state cyclosporine (CSA) levels in children with relapsed and/or refractory acute myeloid leukemia.
  • PATIENTS AND METHODS: MEC therapy consisted of mitoxantrone 6 mg/m(2)/d for 5 days, etoposide 60 mg/m(2)/d for 5 days, and CSA 10 mg/kg for 2 hours followed by 30 mg/kg/d as a continuous infusion for 98 hours.
  • Because of pharmacokinetic interactions, drug doses were decreased to 60% of those found to be effective without coadministration of CSA.
  • In most who had relapsed while receiving therapy or whose induction therapy had failed, response was not significantly different for MDR1-positive and MDR1-negative patients.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Multiple. Genes, MDR / genetics. Leukemia, Myeloid, Acute / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cyclosporine / administration & dosage. Cyclosporine / blood. Cyclosporine / pharmacokinetics. Etoposide / administration & dosage. Female. Flow Cytometry. Humans. Immunosuppressive Agents / administration & dosage. Immunosuppressive Agents / blood. Immunosuppressive Agents / pharmacokinetics. Infant. Infant, Newborn. Infusions, Intravenous. Male. Mitoxantrone / administration & dosage. Recurrence. Reverse Transcriptase Polymerase Chain Reaction. Treatment Outcome

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  • (PMID = 10784627.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA-30969; United States / NCRR NIH HHS / RR / M01 RR 00070; United States / NCI NIH HHS / CA / R01 CA 52168; etc
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 6PLQ3CP4P3 / Etoposide; 83HN0GTJ6D / Cyclosporine; BZ114NVM5P / Mitoxantrone
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5. Hale GA, Tong X, Benaim E, Cunningham JM, Heslop HE, Horwiz EM, Leung W, Rochester RJ, Shearer PD, Srivastava DK, Woodard JP, Bowman LC: Allogeneic bone marrow transplantation in children failing prior autologous bone marrow transplantation. Bone Marrow Transplant; 2001 Jan;27(2):155-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Twenty-three children with de novo acute myelogenous leukemia (AML) (n = 20), secondary AML (n = 1), or non-Hodgkin's lymphoma (NHL) (n = 2) underwent allogeneic bone marrow transplantation (alloBMT) for graft failure (n = 1) or recurrent malignancy (n = 22) between February 1992 and August 1999 following autologous BMT (ABMT).
  • Induction chemotherapy was given to 14 patients and nine patients went directly to alloBMT.
  • Eight patients relapsed at a median of 206 days (range, 35-669 days) post alloBMT and all eventually died.
  • Eight patients (two of whom also relapsed) died of RRT.
  • Although RRT and relapse remain significant problems, a significant percentage of pediatric patients failing ABMT may be cured with alloBMT.
  • [MeSH-major] Bone Marrow Transplantation. Leukemia, Myeloid, Acute / therapy. Lymphoma, Non-Hodgkin / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Infant. Male. Recurrence. Retrospective Studies. Salvage Therapy. Transplantation, Autologous. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 11281384.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P 30CA 21765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
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6. Sievers EL: Antibody-targeted chemotherapy of acute myeloid leukemia using gemtuzumab ozogamicin (Mylotarg). Blood Cells Mol Dis; 2003 Jul-Aug;31(1):7-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Antibody-targeted chemotherapy of acute myeloid leukemia using gemtuzumab ozogamicin (Mylotarg).
  • Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults and accounts for 20% of pediatric leukemia.
  • Although conventional chemotherapy induces clinical remissions in most patients with AML, recurrent leukemia represents the major obstacle to cure.
  • Conventional chemotherapy reinduction is associated with limited efficacy and substantial toxicity.
  • Chemotherapy specifically targeted to leukemic cells by monoclonal antibodies might enable patients to achieve remissions more safely than conventional approaches.
  • Food and Drug Administration approved Mylotarg (gemtuzumab ozogamicin) for the treatment of patients with CD33-positive AML in first relapse who are 60 years of age or older and who are not considered candidates for other types of cytotoxic chemotherapy.
  • Among 277 adult patients with CD33-positive AML in first relapse, 26% experienced an overall response after Mylotarg monotherapy.
  • Despite the fact that myelosuppression, hyperbilirubinemia, and elevated hepatic transaminases were commonly observed, the incidences of severe infections and mucositis were relatively low in comparison with conventional chemotherapeutic treatment.
  • Preliminary reports in pediatric patients also report Mylotarg to be reasonably well tolerated.
  • Recently, data from study regimens combining Mylotarg and conventional chemotherapy suggest an unusually high remission induction rate in de novo AML patients.
  • [MeSH-major] Aminoglycosides / therapeutic use. Antibodies, Monoclonal / therapeutic use. Immunotoxins / therapeutic use. Leukemia, Myeloid / drug therapy
  • [MeSH-minor] Acute Disease. Antibodies, Monoclonal, Humanized. Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Drug Approval. Humans. Treatment Outcome

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  • (PMID = 12850477.001).
  • [ISSN] 1079-9796
  • [Journal-full-title] Blood cells, molecules & diseases
  • [ISO-abbreviation] Blood Cells Mol. Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoglycosides; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0 / Antineoplastic Agents; 0 / Immunotoxins; 0 / gemtuzumab
  • [Number-of-references] 12
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7. Zwerdling T, Krailo M, Monteleone P, Byrd R, Sato J, Dunaway R, Seibel N, Chen Z, Strain J, Reaman G, Children's Oncology Group: Phase II investigation of docetaxel in pediatric patients with recurrent solid tumors: a report from the Children's Oncology Group. Cancer; 2006 Apr 15;106(8):1821-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II investigation of docetaxel in pediatric patients with recurrent solid tumors: a report from the Children's Oncology Group.
  • The current study was designed to determine response rates to docetaxel in various strata of recurrent solid tumors of childhood and to assess toxicity in a group of patients who were assigned to receive it.
  • RESULTS: There were no deaths attributable to study drug.
  • Hematologic toxicity was common during therapy.
  • One patient each had acute myeloid leukemia, acute lymphoid leukemia, and high-grade glioma reported as secondary malignancies.
  • CONCLUSIONS: Docetaxel demonstrated activity in patients with recurrent Ewing sarcoma but was found to be ineffective for treating the other types of recurrent solid tumors that were studied.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Glioma / drug therapy. Glioma / secondary. Neoplasm Recurrence, Local / drug therapy. Sarcoma / drug therapy. Sarcoma / secondary. Taxoids / therapeutic use

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  • [Copyright] 2006 American Cancer Society
  • (PMID = 16532433.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids; 15H5577CQD / docetaxel
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8. Styczynski J, Wysocki M: Ex vivo drug resistance in childhood acute myeloid leukemia on relapse is not higher than at first diagnosis. Pediatr Blood Cancer; 2004 Feb;42(2):195-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Ex vivo drug resistance in childhood acute myeloid leukemia on relapse is not higher than at first diagnosis.
  • Relapsed pediatric patients with acute myeloid leukemia (AML) have a poor clinical prognosis.
  • The aim of this study was the analysis of the ex vivo drug resistance profile on relapse in childhood AML in comparison to newly diagnosed AML.
  • The results of 98 pediatric AML samples tested by the MTT assay were analyzed.
  • Finally, ex vivo drug resistance of 20 relapsed samples were compared with that of 60 de novo AML, including 9 matched pairs.
  • Up to 18 drugs were tested for each patient.
  • No significant differences between drug resistance at diagnosis and at relapse in AML was found, neither for the whole groups of patients, nor for matched pairs only.
  • In summary, cellular drug resistance in childhood AML at relapse is not higher than at first diagnosis.
  • These observations suggest that other, than cellular drug resistance, factors play a key role in therapy failure of relapsed childhood AML.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Drug Resistance, Neoplasm. Leukemia, Myeloid / drug therapy. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Acute Disease. Adolescent. Cell Division / drug effects. Child. Child, Preschool. Cytogenetic Analysis. Drug Screening Assays, Antitumor. Female. Humans. Infant. Infant, Newborn. Male

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 14752887.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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9. Ustün C, Kalla A, Bollag RJ, Manaloo E, Kulharya A, Jillella A: Relapsed acute myelogenous leukemia occurring after 18 years with recurrent novel chromosomal abnormality t(18;22)(q23;q11.2). Cancer Genet Cytogenet; 2007 Sep;177(2):135-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Relapsed acute myelogenous leukemia occurring after 18 years with recurrent novel chromosomal abnormality t(18;22)(q23;q11.2).
  • At age 4, she was diagnosed with acute myelogenous leukemia (AML) with t(18;22)(q23;q11.2) and received chemotherapy until age 6 under a pediatric study protocol.
  • The patient was treated for relapsed AML and at writing had been disease-free for 9 months.
  • Translocation between chromosomes 18 and 22 has been reported in indolent lymphoproliferative disorders, but not in AML.
  • Although we do not know the precise molecular etiology of this leukemia, the uncommon presentation for AML and late relapse with the same chromosomal abnormality may indicate a causal relationship between this novel chromosomal abnormality and the AML.
  • [MeSH-major] Chromosome Aberrations. Chromosomes, Human, Pair 18 / genetics. Chromosomes, Human, Pair 22 / genetics. Leukemia, Myeloid, Acute / genetics. Neoplasm Recurrence, Local / genetics

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  • (PMID = 17854669.001).
  • [ISSN] 0165-4608
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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10. Horton TM, Thompson PA, Berg SL, Adamson PC, Ingle AM, Dolan ME, Delaney SM, Hedge M, Weiss HL, Wu MF, Blaney SM, Children's Oncology Group Study: Phase I pharmacokinetic and pharmacodynamic study of temozolomide in pediatric patients with refractory or recurrent leukemia: a Children's Oncology Group Study. J Clin Oncol; 2007 Nov 1;25(31):4922-8
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  • [Title] Phase I pharmacokinetic and pharmacodynamic study of temozolomide in pediatric patients with refractory or recurrent leukemia: a Children's Oncology Group Study.
  • PURPOSE: To determine the tolerability, pharmacokinetics, and mechanisms of temozolomide resistance in children with relapsed or refractory leukemia.
  • Pretreatment leukemia cell O6-methylguanine-DNA methyltransferase (MGMT) activity, tumor and plasma MGMT promoter methylation, and microsatellite instability (MSI) were examined in 14 of 16 study patients and in tissue bank samples from children with acute leukemia not treated with temozolomide (MGMT, n = 67; MSI, n = 65).
  • RESULTS: Sixteen patients (nine female, seven male; acute lymphoblastic leukemia [ALL], n = 8; acute myeloid leukemia [AML], n = 8), median age 11 years (range, 1 to 19 years), received either 200 mg/m2/d (nine enrolled, three assessable for toxicity) or 260 mg/m2/d (seven enrolled, three assessable for toxicity) of temozolomide.
  • MGMT activity in leukemia cells was quite variable and was highest in patients with relapsed ALL.
  • CONCLUSION: Temozolomide was well tolerated at doses as high as 260 mg/m2/d for 5 days in children with relapsed or refractory leukemia.
  • Increased MGMT activity may account for the temozolomide resistance in children with relapsed leukemia.
  • Leukemia cell MGMT activity was higher in pediatric ALL than AML (P < .0001).
  • [MeSH-major] Antineoplastic Agents, Alkylating / pharmacokinetics. Dacarbazine / analogs & derivatives. Drug Resistance, Neoplasm / genetics. Leukemia / drug therapy. Neoplasm Recurrence, Local / drug therapy

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  • (PMID = 17971589.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / K12CA90433; United States / NCI NIH HHS / CA / P30 CA14599; United States / NCI NIH HHS / CA / U01CA63187; United States / NCI NIH HHS / CA / UO1-CA97452
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Suppressor Proteins; 7GR28W0FJI / Dacarbazine; 85622-93-1 / temozolomide; EC 2.1.1.- / DNA Modification Methylases; EC 2.1.1.63 / MGMT protein, human; EC 6.5.1.- / DNA Repair Enzymes
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11. Sievers EL, Lange BJ, Sondel PM, Krailo MD, Gan J, Tjoa T, Liu-Mares W, Feig SA: Children's cancer group trials of interleukin-2 therapy to prevent relapse of acute myelogenous leukemia. Cancer J Sci Am; 2000 Feb;6 Suppl 1:S39-44
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  • [Title] Children's cancer group trials of interleukin-2 therapy to prevent relapse of acute myelogenous leukemia.
  • PURPOSE: Up to 80% of children with acute myelogenous leukemia treated with intensive chemotherapy achieve remission; however, a large proportion of patients develops recurrent disease.
  • Because interleukin (IL)-2 can induce remission in patients with overt evidence of acute myelogenous leukemia, we hypothesized that it might prevent relapse when administered to patients in first remission after intensive consolidation chemotherapy.
  • A pilot Children's Cancer Group (CCG) trial (CCG-0941) demonstrated the feasibility of this approach, and we initiated a prospective randomized trial (CCG-2961) to further evaluate the safety and potential efficacy of IL-2 therapy in preventing relapse of acute myelogenous leukemia.
  • PATIENTS AND METHODS: In trial CCG-0941, 21 pediatric patients in complete remission following induction and consolidation chemotherapy on protocol CCG-2941 received IL-2 therapy.
  • In CCG-2961, 79 patients in complete remission were randomized as of February 1999 to receive either IL-2 (n = 39) or no further therapy.
  • Hypotension resolved promptly after treatment with intravenous fluids.
  • No patients have experienced renal toxicity or required cardiac vasopressors or transfer to an intensive care unit; there have been no treatment-related deaths.
  • CONCLUSION: The dose and schedule of IL-2 used in these two trials continue to be reasonably well tolerated by children with acute myelogenous leukemia in first remission.

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  • (PMID = 10685657.001).
  • [ISSN] 1081-4442
  • [Journal-full-title] The cancer journal from Scientific American
  • [ISO-abbreviation] Cancer J Sci Am
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R25 CA092049; United States / NCI NIH HHS / CA / CA 13539; United States / NCI NIH HHS / CA / CA 14489; United States / NCRR NIH HHS / RR / MO1-RR00240
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interleukin-2; 0 / Recombinant Proteins
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12. Kaspers GJ, Reinhardt D, Fleischhack G, Armendariz H, Stark B, Zwaan CM, Zimmermann M, Creutzig U: Low efficacy of methotrexate in childhood acute myeloid leukemia (AML): single-agent therapeutic window study in relapsed AML. Pediatr Blood Cancer; 2006 Oct 15;47(5):539-42
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  • [Title] Low efficacy of methotrexate in childhood acute myeloid leukemia (AML): single-agent therapeutic window study in relapsed AML.
  • BACKGROUND: The efficacy in pediatric acute myeloid leukemia (AML) of single-agent methotrexate (MTX) at a higher dose than previously applied, 1,000 mg/m2, given as a theoretically beneficial 36-hr continuous infusion, is unknown, but may be beneficial based on preclinical data.
  • PROCEDURE: We performed a therapeutic window study in children with first relapsed AML treated in four different countries.
  • By that time, another four patients had been enrolled, of which one patient with a late relapsed AML FAB type M7 showed a good response.
  • CONCLUSIONS: This study shows that single-agent MTX in the applied regimen in pediatric relapsed AML has limited efficacy.
  • However, it also demonstrates the feasibility of an international and therapeutic window phase II study in pediatric relapsed AML.
  • [MeSH-major] Leukemia, Myeloid, Acute / drug therapy. Methotrexate / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Dose-Response Relationship, Drug. Female. Humans. Infant. Infusions, Intravenous. Male. Maximum Tolerated Dose. Recurrence. Treatment Outcome


13. Tomizawa D, Koh K, Hirayama M, Miyamura T, Hatanaka M, Saikawa Y, Ishii E: Outcome of recurrent or refractory acute lymphoblastic leukemia in infants with MLL gene rearrangements: A report from the Japan Infant Leukemia Study Group. Pediatr Blood Cancer; 2009 Jul;52(7):808-13
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  • [Title] Outcome of recurrent or refractory acute lymphoblastic leukemia in infants with MLL gene rearrangements: A report from the Japan Infant Leukemia Study Group.
  • BACKGROUND: Despite the poor outcome of recurrent or refractory acute lymphoblastic leukemia (ALL) in infants with MLL gene rearrangement, few studies have focused on this specific group.
  • We conducted a retrospective analysis of infants with recurrent or refractory ALL from two previous consecutive Japanese studies to clarify the characteristics and prognostic factors among these patients PROCEDURE: All recurrent or refractory ALL infants with MLL gene rearrangement (MLL-R) who were registered in two consecutive Japanese nation-wide multicentric trials (MLL96 and MLL98; between 1995 and 2001) were eligible for the study.
  • With median follow-up period of 5.5 years, the 5-year overall survival (OS) rate after the second-line treatment was 25.6% +/- 6.9%.
  • Young age (<3 months) and central nervous system involvement at initial diagnosis were associated with poor outcome; however, failure to achieve remission after salvage therapy was the sole independent poor prognostic factor in multivariate analysis (P = 0.01).
  • CONCLUSIONS: The prognosis of infants with recurrent or refractory MLL-R ALL is extremely poor despite alternative treatments including HSCT; therefore, it is necessary to develop novel treatment strategies.
  • [MeSH-major] Drug Resistance, Neoplasm. Myeloid-Lymphoid Leukemia Protein / genetics. Neoplasm Recurrence, Local / genetics. Neoplasm Recurrence, Local / therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Transplantation. Combined Modality Therapy. Disease-Free Survival. Female. Gene Rearrangement. Hematopoietic Stem Cell Transplantation. Histone-Lysine N-Methyltransferase. Humans. Infant. Male. Peripheral Blood Stem Cell Transplantation. Prognosis. Remission Induction. Retrospective Studies. Salvage Therapy. Survival Rate. Transplantation Conditioning. Treatment Outcome

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  • [Copyright] (c) 2009 Wiley-Liss, Inc.
  • (PMID = 19229974.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / MLL protein, human; 149025-06-9 / Myeloid-Lymphoid Leukemia Protein; EC 2.1.1.43 / Histone-Lysine N-Methyltransferase
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14. Bell BA, Chang MN, Weinstein HJ: A phase II study of Homoharringtonine for the treatment of children with refractory or recurrent acute myelogenous leukemia: a pediatric oncology group study. Med Pediatr Oncol; 2001 Aug;37(2):103-7
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  • [Title] A phase II study of Homoharringtonine for the treatment of children with refractory or recurrent acute myelogenous leukemia: a pediatric oncology group study.
  • The treatment of acute myelogenous leukemia (AML) in children, has been hampered by few new effective agents developed in the past 30 years.
  • The purpose of this study is to evaluate the efficacy and toxicity of HHT for the therapy of refractory AML in children.
  • PROCEDURE: Patients entered the study and were treated with HHT 7mg/m(2)/day for 10 days.
  • CONCLUSIONS: HHT has activity against chemotherapy resistant AML in children, with tolerable toxicity.
  • This agent warrants further clinical evaluation in combination with other agents or perhaps biologic response modifiers which will hopefully lead to useful therapeutic options.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / pharmacology. Harringtonines / pharmacology. Leukemia, Myeloid, Acute / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Disease Progression. Drug Resistance, Neoplasm. Female. Humans. Infant. Infusions, Intravenous. Male. Neutropenia / chemically induced. Thrombocytopenia / chemically induced. Treatment Outcome

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  • [Copyright] Copyright 2001 Wiley-Liss, Inc.
  • (PMID = 11496347.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 03161; United States / NCI NIH HHS / CA / CA 05587; United States / NCI NIH HHS / CA / CA 11233; United States / NCI NIH HHS / CA / CA 20549; United States / NCI NIH HHS / CA / CA 25408; United States / NCI NIH HHS / CA / CA 28383; United States / NCI NIH HHS / CA / CA 28476; United States / NCI NIH HHS / CA / CA 29139; United States / NCI NIH HHS / CA / CA 32053; United States / NCI NIH HHS / CA / CA 33603; United States / NCI NIH HHS / CA / CA 35587; United States / NCI NIH HHS / CA / CA 69177; United States / NCI NIH HHS / CA / CA 69428; United States / NCI NIH HHS / CA / CA15089; United States / NCI NIH HHS / CA / CA30969
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / Harringtonines; 6FG8041S5B / homoharringtonine
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15. Shearer P, Kapoor G, Beckwith JB, Takashima J, Breslow N, Green DM: Secondary acute myelogenous leukemia in patients previously treated for childhood renal tumors: a report from the National Wilms Tumor Study Group. J Pediatr Hematol Oncol; 2001 Feb;23(2):109-11
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  • [Title] Secondary acute myelogenous leukemia in patients previously treated for childhood renal tumors: a report from the National Wilms Tumor Study Group.
  • PURPOSE: This review characterized cases of secondary acute myelogenous leukemia (AML) occurring after treatment of renal neoplasms on protocols of the National Wilms Tumor Study Group (NWTSG) between October 1969 and December 1991.
  • PATIENTS AND METHODS: The NWTSG database was reviewed for cases of secondary AML and for WT1 status of the affected patients.
  • Referring institutions were contacted by a confidential letter requesting pathology reports, results of immunophenotyping, cytogenetic, and molecular analyses, and details concerning treatment of AML.
  • RESULTS: Of the 5,278 patients treated during the study period, 43 had second malignant neoplasms, and 7 of these 43 had AML.
  • At the time of diagnosis of Wilms tumor, the median age of the seven patients (4 boys) was 3.2 years.
  • One patient had bilateral tumors, and two were treated for recurrent Wilms tumor.
  • All patients received chemotherapy regimens that included doxorubicin (6) or etoposide (1), and six were treated with infradiaphragmatic irradiation.
  • The median latency period from initial diagnosis of the renal neoplasm to development of secondary AML was 3 years (range, 1.2-4 yrs).
  • CONCLUSIONS: The development of secondary AML in this subset of patients after treatment of renal neoplasms may reflect the interaction of the effects of treatment and possible genetic predisposition toward cancer.
  • [MeSH-major] Leukemia, Myeloid / epidemiology. Neoplasms, Second Primary / epidemiology. Wilms Tumor / therapy
  • [MeSH-minor] Abnormalities, Multiple / epidemiology. Acute Disease. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Cohort Studies. Comorbidity. Databases, Factual. Female. Fetal Growth Retardation / epidemiology. Humans. Infant. Leukemia, Radiation-Induced / epidemiology. Leukemia, Radiation-Induced / etiology. Male. Neoplasms, Multiple Primary / epidemiology. Radiotherapy, Adjuvant / adverse effects. Retrospective Studies. Survival Analysis. Treatment Outcome. United States / epidemiology

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  • (PMID = 11216701.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Kebudi R, Görgün O, Ayan I: Oral etoposide for recurrent/progressive sarcomas of childhood. Pediatr Blood Cancer; 2004 Apr;42(4):320-4
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  • [Title] Oral etoposide for recurrent/progressive sarcomas of childhood.
  • BACKGROUND: Etoposide (VP-16) is a topoisomerase II inhibitor that is effective in a broad spectrum of pediatric and adult malignancies.
  • Chronic, low-dose, oral VP-16 has also been shown to be active in some recurrent malignancies mostly in adults.
  • The aim of this prospective, single institution study is to assess the efficacy and toxicity of oral VP-16 in children with progressive or recurrent (P/R) sarcomas.
  • PROCEDURE: Twenty-one children (10 girls and 11 boys) with R/P sarcomas and a median age of 11 years (range 3-16 years) were enrolled in this study.
  • The diagnosis was Ewing sarcoma family tumor (ESFT) in seven, osteosarcoma in eight, rhabdomyosarcoma in four, clear cell sarcoma of soft tissue in one, fibrosarcoma in one patient.
  • They are alive with no evidence of disease (NED) 79 and 94 months from time of relapse/progressive disease (PD).
  • A patient developed acute myeloid leukemia and died.
  • There was no major acute toxicity related to oral VP-16 in a total of 126 courses.
  • CONCLUSIONS: Oral VP-16 therapy is simple, relatively nontoxic, and does not necessitate hospitalization.
  • Given the risk of second malignancy, especially in children with previous exposure to topoisomerase II inhibitors and alkylating agents, this regimen may be used as a palliative treatment or in patients with poor prognosis.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Etoposide / administration & dosage. Sarcoma / drug therapy
  • [MeSH-minor] Administration, Oral. Adolescent. Child. Child, Preschool. Disease Progression. Female. Humans. Male. Neoplasms, Second Primary / chemically induced. Palliative Care. Recurrence. Remission Induction. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 14966827.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide
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17. Kim IS, Kim HJ, Yoo KH, Sung KW, Kim SH: A boy with acute lymphoblastic leukemia acquired clonal and nonclonal cytogenetic abnormalities including del(7q) and del(20q) without clinical evidence of disease after sex-mismatched cord blood transplantation. J Pediatr Hematol Oncol; 2006 Aug;28(8):540-3
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  • [Title] A boy with acute lymphoblastic leukemia acquired clonal and nonclonal cytogenetic abnormalities including del(7q) and del(20q) without clinical evidence of disease after sex-mismatched cord blood transplantation.
  • An 8-year-old boy was diagnosed with precursor B-cell acute lymphoblastic leukemia.
  • After intensified chemotherapy, he underwent sex-mismatched allogeneic cord blood transplantation.
  • Postcord blood transplantation cytogenetic studies revealed engraftment failure evidenced by switching into the recipient type (XY), and, notably, various complex chromosomal aberrations in the recipient cells.
  • Del(7q) and del(20q), 2 recurrent chromosomal aberrations in myeloid neoplasia, might represent underlying genomic instability in this patient, not the direct culprits of dysplasia or leukemogenesis.
  • [MeSH-minor] Child. Chromosome Deletion. Histocompatibility Testing / methods. Humans. Male. Remission Induction. Sensitivity and Specificity. Tomography, X-Ray Computed / methods. Transplantation Conditioning / methods. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 16912597.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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18. Matsubara H, Makimoto A, Takayama J, Higa T, Saito T, Kanda Y, Tanosaki R, Mineishi S, Ohira M, Takaue Y: Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia. Jpn J Clin Oncol; 2001 Jan;31(1):30-4
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  • [Title] Possible clinical benefits of the use of peripheral blood stem cells over bone marrow in the allogeneic transplantation setting for the treatment of childhood leukemia.
  • BACKGROUND: The benefits of allogeneic peripheral blood stem/progenitor cell transplantation (PBSCT) over bone marrow transplantation (BMT), if any, have not been seriously evaluated in a pediatric population.
  • We report here our experience with this procedure and demonstrate rapid engraftment to reduce procedure-related complications and enhanced allogeneic immune reaction to reduce leukemic relapse.
  • Four patients (2 AML and 2 ALL, aged 8-18 years) underwent allogeneic PBSCT for relapsed leukemia after primary allogeneic BMT (n = 2), for active hepatosplenic fungal abscess (n = 1) or for refractory relapse with conventional chemotherapy (n = 1).
  • RESULTS: No significant toxicities were observed in normal donors on G-CSF treatment or at collection of PBSC.
  • After PBSCT, no significant acute toxicities were observed and the median duration to an absolute granulocyte count of 0.5 x 10(9)/l and a platelet count of 20 x 10(9)/l was 16 and 21 days, respectively.
  • Although none of our patients developed acute graft-versus-host disease (GVHD), two developed chronic GVHD involving the liver and skin.
  • Among those who developed chronic GVHD, one died of recurrent disease and another died of pneumonia 235 days after PBSCT.
  • CONCLUSIONS: Allogeneic PBSCT can be a safe procedure in a pediatric population with fewer acute complications, although the potential risk of G-CSF treatment in normal donors should be seriously weighed against the existing risks of marrow aspiration under general anesthesia.
  • The risk of chronic GVHD may need to be balanced against a possible graft-versus-leukemia benefit in patients at higher risk of leukemic relapse.
  • [MeSH-major] Bone Marrow Transplantation. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Acute / therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • [MeSH-minor] Adolescent. Child. Feasibility Studies. Female. Graft Survival. Graft vs Host Disease. Graft vs Leukemia Effect / immunology. HLA Antigens / immunology. Hematopoietic Stem Cell Mobilization. Humans. Male. Middle Aged. Retrospective Studies. Treatment Outcome

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  • MedlinePlus Health Information. consumer health - Acute Myeloid Leukemia.
  • MedlinePlus Health Information. consumer health - Bone Marrow Transplantation.
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  • (PMID = 11256838.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / HLA Antigens
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19. Ozsahin H, Wacker P, Brundler MA, Starobinski M, Helg C, Pastore Y, Miralbell R, Hanquinet S, Gervaix A, Chapuis B, Humbert J: Fatal myocardial aspergillosis in an immunosuppressed child. J Pediatr Hematol Oncol; 2001 Oct;23(7):456-9
Hazardous Substances Data Bank. AMPHOTERICIN B .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A girl with resistant acute myeloid leukemia (AML) had a stem cell transplantation.
  • Preceding transplantation, she had recurrent pneumonitis.
  • [MeSH-minor] Amphotericin B / therapeutic use. Antifungal Agents / therapeutic use. Aspergillus / isolation & purification. Child. Fatal Outcome. Female. Hematopoietic Stem Cell Transplantation. Humans. Immunocompromised Host. Leukemia, Myeloid, Acute / complications. Leukemia, Myeloid, Acute / drug therapy. Lung Diseases, Fungal / drug therapy. Lung Diseases, Fungal / microbiology

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  • (PMID = 11878582.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antifungal Agents; 7XU7A7DROE / Amphotericin B
  • [Number-of-references] 10
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