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2012 ; 47
(11
): 1448-54
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
A phase I/II study of CY and topotecan in patients with high-risk malignancies
undergoing autologous hematopoietic cell transplantation: the St Jude long-term
follow-up
#MMPMID22426752
Kasow KA
; Stewart CF
; Barfield RC
; Wright NL
; Li C
; Srivastava DK
; Leung W
; Horwitz EM
; Bowman LC
; Handgretinger R
; Hale GA
Bone Marrow Transplant
2012[Nov]; 47
(11
): 1448-54
PMID22426752
show ga
Fifty-eight consecutive children with high-risk malignancies were treated with
CY, and targeted topotecan followed by autologous hematopoietic cell
transplantation (AHCT) in a phase I/II Institutional Review Board-approved study.
Twelve participants enrolled in phase I; 5 received dose level 1 of topotecan
3?mg/m(2) per day, with subsequent doses targeted to total systemic exposure of
100±20?ng?h/mL and CY 750?mg/m(2) per day. Seven participants received dose level
2. CY dose escalation to 1?g/m(2) per day was considered excessively toxic; one
died from irreversible veno-occlusive disease and two experienced reversible
hepatotoxicity. These adverse events halted further dose escalation. A total of
46 participants were enrolled in phase II; results are on the 51 participants who
received therapy at dose level 1, the maximum tolerated dose. Diagnoses included
neuroblastoma (26), sarcoma (9), lymphoma (8), brain tumors (5), Wilms (2) and
retinoblastoma (1). Twenty participants (39.3%) were in ?CR1 at enrollment;
median age was 5.1 years. Most common non-hematological grade III-IV toxicity was
gastrointestinal (n=37). Neutrophil and platelet engraftment occurred at a median
of 15 and 24 days, respectively. Twenty-six (51%) participants remain alive at a
median of 6.4 years after AHCT. CY 3.75?g/m(2), and targeted topotecan followed
by AHCT are feasible and produce acceptable toxicity in children with high-risk
malignancies.
|Adolescent
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
[MESH]