PMID- 9041170
OWN - NLM
STAT- MEDLINE
DCOM- 19970320
LR  - 20190620
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 79
IP  - 5
DP  - 1997 Mar 1
TI  - Treatment of children with epipodophyllotoxin-induced secondary acute myeloid 
      leukemia.
PG  - 1049-54
AB  - BACKGROUND: Secondary acute myeloid leukemia (AML) after treatment with 
      epipodophyllotoxins is being observed with increased frequency. Therapeutic 
      options are limited for patients with secondary AML and the role of bone marrow 
      transplantation is unclear. METHODS: The authors report the treatment outcome of 
      a cohort of 17 children who developed epipodophyllotoxin-induced secondary AML 
      after therapy for childhood acute lymphoblastic leukemia (ALL) that included 
      etoposide but no irradiation or alkylating agents. Thirteen patients (76%) had 
      11q23 chromosomal abnormalities that were not present at the initial diagnosis of 
      ALL. RESULTS: Remission induction was attempted in 16 children, with 13 (81%) 
      achieving a complete remission. After consolidation, 9 of these 13 patients 
      received a bone marrow transplant (BMT): 2 with 
      4-hydroperoxycyclophosphamide-purged autologous marrow, 4 from a human leukocyte 
      antigen (HLA)-identical sibling, 1 from a mismatched parental donor, and 2 from a 
      matched unrelated donor. One additional child underwent allogeneic BMT without an 
      attempt at reinduction. Of the 10 patients who received transplants, 2 were alive 
      and well 27+ and 36+ months, respectively, after BMT. Of the 7 patients who did 
      not receive a transplant, at last follow-up 1 had survived off therapy for 8 
      months for recurrent ALL whereas 6 died of AML. CONCLUSIONS: These data confirm 
      the poor prognosis of secondary AML after epipodophyllotoxin treatment for 
      childhood ALL. Although patients with secondary AML can achieve a remission, it 
      is usually of brief duration. Allogeneic BMT may offer the possibility of long 
      term remission in some of these patients. More information is needed to better 
      define the risks and benefits of epipodophyllotoxin therapy for childhood ALL.
FAU - Sandler, E S
AU  - Sandler ES
AD  - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 
      75235-9063, USA.
FAU - Friedman, D J
AU  - Friedman DJ
FAU - Mustafa, M M
AU  - Mustafa MM
FAU - Winick, N J
AU  - Winick NJ
FAU - Bowman, W P
AU  - Bowman WP
FAU - Buchanan, G R
AU  - Buchanan GR
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - L36H50F353 (Podophyllotoxin)
SB  - IM
MH  - Acute Disease
MH  - Bone Marrow Transplantation
MH  - *Burkitt Lymphoma
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Infant
MH  - Leukemia, Myeloid/*chemically induced/therapy
MH  - Male
MH  - Neoplasms, Second Primary/*chemically induced/therapy
MH  - Podophyllotoxin/*adverse effects
MH  - Survival Analysis
EDAT- 1997/03/01 00:00
MHDA- 2000/06/20 09:00
CRDT- 1997/03/01 00:00
PHST- 1997/03/01 00:00 [pubmed]
PHST- 2000/06/20 09:00 [medline]
PHST- 1997/03/01 00:00 [entrez]
AID - 10.1002/(SICI)1097-0142(19970301)79:5<1049::AID-CNCR24>3.0.CO;2-0 [pii]
AID - 10.1002/(sici)1097-0142(19970301)79:5<1049::aid-cncr24>3.0.co;2-0 [doi]
PST - ppublish
SO  - Cancer. 1997 Mar 1;79(5):1049-54. doi: 
      10.1002/(sici)1097-0142(19970301)79:5<1049::aid-cncr24>3.0.co;2-0.