Management of Refractory/Relapsed Acute Leukemia with Heart Limitation by Anthracycline-free Chemotherapy Regimens in Pediatric Patients: New Hypothesis and New Approach

Abdolkarimi, Babak and Zareifar, Soheila and Karimi, Mehran and Salajegheh, Pouria (2018) Management of Refractory/Relapsed Acute Leukemia with Heart Limitation by Anthracycline-free Chemotherapy Regimens in Pediatric Patients: New Hypothesis and New Approach. Middle East Journal of Cancer, 9 (2). pp. 77-84.

[img]
Preview
Text
Management of refractory relapsed acute leukemia with heart limitation by anthracycline-free chemotherapy regimens in pediatric patients New hypothesis and new approach.pdf

Download (172kB) | Preview

Abstract

Background: Anthracycline therapy for acute leukemia may be associated with significant morbidity and mortality in children or elderly patients that have a degree of heart failure. Patients with prior anthracycline exposure, those with pre-existing heart disease, or who have received the total anthracycline dose present an increased risk for cardiotoxicity. Therefore, new chemotherapy regimensin these situations would be life saving for leukemia patients. We have conducted a systematic review of possible strategies for rescue regimens without anthracycline in refractory acute leukemia patients. Methods: We gathered the data from 5 creation databases and relevant website until August 2016. We selected randomized clinical trials or other studies that used anthracycline-free chemotherapy regimens to treat acute refractory leukemia in children and adults. The quality of the studies was evaluated according to the Cochrane risk of the polarization tool. All stages of the review were independently conducted by two authors. We obtained data from 75 main clinical trials. Results: There were 75 trials included from which 4 were considered to be at low risk for bias. Most trials showed that the improvement did not reach statistical significance. Conclusion: Evidence existed to support the use of the combination of fludarabine, cytarabine, and filgrastim, ICE-rituximab chemotherapy regimens, or monoclonal antibodies such as tyrosine kinase inhibitors (Sorafenib) useful for acute refractory/relapsed leukemia.These drugs are used as first salvage regimens or clofarabine and cladribine for acute myeloid leukemia in patients for whom combined anthracycline chemotherapy is inappropriate.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine, Health and Life Sciences > School of Medicine
Depositing User: sobhan rezaiian
Date Deposited: 29 May 2018 06:45
Last Modified: 29 May 2018 06:45
URI: http://eprints.lums.ac.ir/id/eprint/1310

Actions (login required)

View Item View Item