High-dose cyclophosphamide for the treatment of refractory T-cell acute lymphoblastic leukemia in children Journal Article
| Authors: | Kobos, R.; Shukla, N.; Renaud, T.; Prockop, S. E.; Boulad, F.; Steinherz, P. G. |
| Article Title: | High-dose cyclophosphamide for the treatment of refractory T-cell acute lymphoblastic leukemia in children |
| Abstract: | Despite an almost 80% overall survival rate in pediatric T-cell acute lymphoblastic leukemia (T-ALL), there is a subset of patients who are refractory to standard chemotherapy regimens and could benefit from novel treatment approaches. Over a 2-year period, we treated 5 pediatric patients with refractory T-ALL, aged 3 to 15 years, with high-dose cyclophosphamide (CY) at a dose of 2100 mg/m for 2 consecutive days either alone (n=1) or in combination with other chemotherapy agents (n=4). Four of these 5 patients had a 1.5 log decrease in disease burden. Three of the 5 patients had no evidence of minimal residual disease (MRD) after high-dose CY. One patient developed transient grade 4 transaminitis and 1 patient developed grade 3 typhlitis. All 5 patients ultimately proceeded to hematopoietic stem cell transplant when MRD levels were <0.01%. Pediatric T-ALL patients with persistent MRD after treatment with conventional chemotherapy may respond to CY at escalated dosing. Copyright © 2014 by Lippincott Williams & Wilkins. |
| Keywords: | adolescent; child; clinical article; preschool child; school child; treatment response; antibiotic agent; human cell; prednisone; drug tolerability; neutropenia; cancer combination chemotherapy; monotherapy; treatment duration; cancer patient; cytarabine; methotrexate; drug megadose; infection; multiple cycle treatment; cyclophosphamide; dexamethasone; vincristine; kidney failure; hematopoietic stem cell transplantation; continuous infusion; oncology; retrospective study; acute lymphoblastic leukemia; drug dose escalation; disease severity; minimal residual disease; cardiotoxicity; daunorubicin; glucocorticoid; ondansetron; clostridium difficile infection; aminotransferase; mesna; recombinant granulocyte colony stimulating factor; childhood leukemia; t cell leukemia; hemorrhagic cystitis; inappropriate vasopressin secretion; alemtuzumab; infusion fluid; typhlitis; hypertransaminasemia; nelarabine; antileukemic agent; asparaginase macrogol; neutropenic enterocolitis; high-dose cyclophosphamide; human; male; priority journal; article; pediatric t-all |
| Journal Title: | Journal of Pediatric Hematology/Oncology |
| Volume: | 36 |
| Issue: | 5 |
| ISSN: | 1077-4114 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2014-07-01 |
| Start Page: | e265 |
| End Page: | e270 |
| Language: | English |
| DOI: | 10.1097/mph.0000000000000080 |
| PROVIDER: | scopus |
| PUBMED: | 24327129 |
| DOI/URL: | |
| Notes: | Export Date: 1 August 2014 -- CODEN: JPHOF -- Source: Scopus |
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