Acute and late toxicities of pirarubicin in the treatment of childhood acute lymphoblastic leukemia: results from a clinical trial by the Japan Association of Childhood Leukemia Study

For the Japan Association of Childhood Leukemia Study

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Anthracyclines are used to treat childhood acute lymphoblastic leukemia (ALL). Even when administered at low doses, these agents are reported to cause progressive cardiac dysfunction. We conducted a clinical trial comparing the toxicities of two anthracyclines, pirarubicin (THP) and daunorubicin (DNR), in the treatment of childhood ALL. The results from our study that relate to acute and late toxicities are reported here. Methods: 276 children with B-ALL were enrolled in the trial from April 1997 to March 2002 and were randomly assigned to receive a regimen including either THP (25 mg/m2 × 11) or DNR (30 mg/m2 × 11). Acute toxicity was prospectively assessed based on the National Cancer Institute Common Toxicity Criteria. Acute hematological toxicity was also examined via some parameters. Patients with event-free survival of >5 years were retrospectively surveyed for cardiac function at 5 and 10 years and at the most recent assessment more than 10 years from the onset of ALL. Results: Acute hematological toxicity in the early phase was more significant in the THP arm. Based on ultrasound cardiography, cardiac function was impaired in both groups during the follow-up period, but there was no significant difference between the groups except for a greater decline in fractional shortening on ultrasound cardiography in the DNR arm. Conclusions: While acute hematological toxicity was more significant in the THP arm, THP also appeared to be less cardiotoxic. However, the evaluation of late cardiotoxicity was limited because only a few subjects were followed beyond 10 years after ALL onset. Considering that the THP regimen produced an EFS rate comparable with that of the DNR regimen, the efficacy and toxicity of THP at reduced doses should be studied in order to identify potentially safer regimens.

Original languageEnglish
Pages (from-to)387-396
Number of pages10
JournalInternational Journal of Clinical Oncology
Volume22
Issue number2
DOIs
Publication statusPublished - Apr 1 2017
Externally publishedYes

Fingerprint

Anthracyclines
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Japan
Leukemia
Clinical Trials
Daunorubicin
Therapeutics
National Cancer Institute (U.S.)
pirarubicin
Disease-Free Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hematology
  • Oncology

Cite this

Acute and late toxicities of pirarubicin in the treatment of childhood acute lymphoblastic leukemia : results from a clinical trial by the Japan Association of Childhood Leukemia Study. / For the Japan Association of Childhood Leukemia Study.

In: International Journal of Clinical Oncology, Vol. 22, No. 2, 01.04.2017, p. 387-396.

Research output: Contribution to journalArticle

@article{360ff581b26944f181af40948ff1c193,
title = "Acute and late toxicities of pirarubicin in the treatment of childhood acute lymphoblastic leukemia: results from a clinical trial by the Japan Association of Childhood Leukemia Study",
abstract = "Background: Anthracyclines are used to treat childhood acute lymphoblastic leukemia (ALL). Even when administered at low doses, these agents are reported to cause progressive cardiac dysfunction. We conducted a clinical trial comparing the toxicities of two anthracyclines, pirarubicin (THP) and daunorubicin (DNR), in the treatment of childhood ALL. The results from our study that relate to acute and late toxicities are reported here. Methods: 276 children with B-ALL were enrolled in the trial from April 1997 to March 2002 and were randomly assigned to receive a regimen including either THP (25 mg/m2 × 11) or DNR (30 mg/m2 × 11). Acute toxicity was prospectively assessed based on the National Cancer Institute Common Toxicity Criteria. Acute hematological toxicity was also examined via some parameters. Patients with event-free survival of >5 years were retrospectively surveyed for cardiac function at 5 and 10 years and at the most recent assessment more than 10 years from the onset of ALL. Results: Acute hematological toxicity in the early phase was more significant in the THP arm. Based on ultrasound cardiography, cardiac function was impaired in both groups during the follow-up period, but there was no significant difference between the groups except for a greater decline in fractional shortening on ultrasound cardiography in the DNR arm. Conclusions: While acute hematological toxicity was more significant in the THP arm, THP also appeared to be less cardiotoxic. However, the evaluation of late cardiotoxicity was limited because only a few subjects were followed beyond 10 years after ALL onset. Considering that the THP regimen produced an EFS rate comparable with that of the DNR regimen, the efficacy and toxicity of THP at reduced doses should be studied in order to identify potentially safer regimens.",
author = "{For the Japan Association of Childhood Leukemia Study} and Hiroki Hori and Tooru Kudoh and Shinichiro Nishimura and Megumi Oda and Makoto Yoshida and Junichi Hara and Akio Tawa and Ikuya Usami and Akihiko Tanizawa and Keiko Yumura-Yagi and Koji Kato and Ryoji Kobayashi and Yoshihiro Komada and Keitaro Matsuo and Keizo Horibe",
year = "2017",
month = "4",
day = "1",
doi = "10.1007/s10147-016-1062-1",
language = "English",
volume = "22",
pages = "387--396",
journal = "International Journal of Clinical Oncology",
issn = "1341-9625",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Acute and late toxicities of pirarubicin in the treatment of childhood acute lymphoblastic leukemia

T2 - results from a clinical trial by the Japan Association of Childhood Leukemia Study

AU - For the Japan Association of Childhood Leukemia Study

AU - Hori, Hiroki

AU - Kudoh, Tooru

AU - Nishimura, Shinichiro

AU - Oda, Megumi

AU - Yoshida, Makoto

AU - Hara, Junichi

AU - Tawa, Akio

AU - Usami, Ikuya

AU - Tanizawa, Akihiko

AU - Yumura-Yagi, Keiko

AU - Kato, Koji

AU - Kobayashi, Ryoji

AU - Komada, Yoshihiro

AU - Matsuo, Keitaro

AU - Horibe, Keizo

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background: Anthracyclines are used to treat childhood acute lymphoblastic leukemia (ALL). Even when administered at low doses, these agents are reported to cause progressive cardiac dysfunction. We conducted a clinical trial comparing the toxicities of two anthracyclines, pirarubicin (THP) and daunorubicin (DNR), in the treatment of childhood ALL. The results from our study that relate to acute and late toxicities are reported here. Methods: 276 children with B-ALL were enrolled in the trial from April 1997 to March 2002 and were randomly assigned to receive a regimen including either THP (25 mg/m2 × 11) or DNR (30 mg/m2 × 11). Acute toxicity was prospectively assessed based on the National Cancer Institute Common Toxicity Criteria. Acute hematological toxicity was also examined via some parameters. Patients with event-free survival of >5 years were retrospectively surveyed for cardiac function at 5 and 10 years and at the most recent assessment more than 10 years from the onset of ALL. Results: Acute hematological toxicity in the early phase was more significant in the THP arm. Based on ultrasound cardiography, cardiac function was impaired in both groups during the follow-up period, but there was no significant difference between the groups except for a greater decline in fractional shortening on ultrasound cardiography in the DNR arm. Conclusions: While acute hematological toxicity was more significant in the THP arm, THP also appeared to be less cardiotoxic. However, the evaluation of late cardiotoxicity was limited because only a few subjects were followed beyond 10 years after ALL onset. Considering that the THP regimen produced an EFS rate comparable with that of the DNR regimen, the efficacy and toxicity of THP at reduced doses should be studied in order to identify potentially safer regimens.

AB - Background: Anthracyclines are used to treat childhood acute lymphoblastic leukemia (ALL). Even when administered at low doses, these agents are reported to cause progressive cardiac dysfunction. We conducted a clinical trial comparing the toxicities of two anthracyclines, pirarubicin (THP) and daunorubicin (DNR), in the treatment of childhood ALL. The results from our study that relate to acute and late toxicities are reported here. Methods: 276 children with B-ALL were enrolled in the trial from April 1997 to March 2002 and were randomly assigned to receive a regimen including either THP (25 mg/m2 × 11) or DNR (30 mg/m2 × 11). Acute toxicity was prospectively assessed based on the National Cancer Institute Common Toxicity Criteria. Acute hematological toxicity was also examined via some parameters. Patients with event-free survival of >5 years were retrospectively surveyed for cardiac function at 5 and 10 years and at the most recent assessment more than 10 years from the onset of ALL. Results: Acute hematological toxicity in the early phase was more significant in the THP arm. Based on ultrasound cardiography, cardiac function was impaired in both groups during the follow-up period, but there was no significant difference between the groups except for a greater decline in fractional shortening on ultrasound cardiography in the DNR arm. Conclusions: While acute hematological toxicity was more significant in the THP arm, THP also appeared to be less cardiotoxic. However, the evaluation of late cardiotoxicity was limited because only a few subjects were followed beyond 10 years after ALL onset. Considering that the THP regimen produced an EFS rate comparable with that of the DNR regimen, the efficacy and toxicity of THP at reduced doses should be studied in order to identify potentially safer regimens.

UR - http://www.scopus.com/inward/record.url?scp=84995784268&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995784268&partnerID=8YFLogxK

U2 - 10.1007/s10147-016-1062-1

DO - 10.1007/s10147-016-1062-1

M3 - Article

C2 - 27858183

AN - SCOPUS:84995784268

VL - 22

SP - 387

EP - 396

JO - International Journal of Clinical Oncology

JF - International Journal of Clinical Oncology

SN - 1341-9625

IS - 2

ER -