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- Title
Ifosfamide with mesna uroprotection and etoposide in recurrent, refractory acute leukemia in childhood. A Pediatric Oncology Group Study.
- Authors
Bernstein, Mark L.; Michael Whitehead, V.; Devine, Susan; Grier, Holcombe; Kung, Faith; Krischer, Jeffrey; Dreyer, Zoanne; Bell, Beverly; Land, Vita; Buchanan, George R.; Pratt, Charles; Bernstein, M L; Whitehead, V M; Devine, S; Grier, H; Kung, F; Krischer, J; Dreyer, Z; Bell, B; Land, V
- Abstract
<bold>Background: </bold>Ifosfamide has previously been shown to be active as a single agent and in combination with doxorubicin, etoposide, and teniposide in pediatric solid tumors and adult acute leukemia. The authors performed a dose-escalation trial of ifosfamide with a fixed dosage of etoposide, with mesna uroprotection, in children with multiply recurrent acute leukemia.<bold>Methods: </bold>Chemotherapy was administered daily for 5 days. Etoposide 100 mg/m2 was followed by ifosfamide at an initial dosage of 1.6 g/m2. The ifosfamide was escalated in 20% increments to the maximum tolerated dosage in cohorts of three patients. Mesna 400 mg/m2 was given immediately before the ifosfamide and then at 3 and 6 hours after ifosfamide in the initial patients. Subsequent patients were treated with mesna 400 mg/m2 just before ifosfamide, and then every 2 hours to a total dosage equal to the ifosfamide dosage.<bold>Results: </bold>Forty-four heavily pretreated patients were entered on study. Forty were evaluable for toxicity and 36 for response as well. The maximum tolerated dosage of ifosfamide was 4.0 g/m2/d for 5 days (20 g/m2/course). Overall, 10 patients achieved complete remission, and 3 achieved partial remission. Remissions were brief, although four patients went on to bone marrow transplant while in remission. One patient is still alive.<bold>Conclusions: </bold>The combination of etoposide and ifosfamide with mesna uroprotection showed promising activity in children with multiply recurrent acute leukemia.
- Publication
Cancer (0008543X), 1993, Vol 72, Issue 5, p1790
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/1097-0142(19930901)72:5<1790::AID-CNCR2820720545>3.0.CO;2-4