Absence of secondary malignant neoplasms in children with high-risk acute lymphoblastic leukemia treated with dexrazoxane
Absence of secondary malignant neoplasms in children with high-risk acute lymphoblastic leukemia treated with dexrazoxane
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DOI：
10.1200/jco.2007.12.2481
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发表时间：
2008-03-01
影响因子：
45.3
通讯作者：
Silverman, Lewis B.
中科院分区：
文献类型：
--
作者：
Barry, Elly V.;Vrooman, Lynda M.;Silverman, Lewis B.
目的dexrazoxane是一种用于预防蒽环类药物引起的心脏毒性的药物。最近的一份报告发现，在患有霍奇金病的儿童中，dexrazoxane的使用与发生继发性恶性肿瘤（smn）的风险之间存在关联。我们报道，在接受丹娜-法伯癌症研究所ALL联合方案95-01治疗的急性淋巴细胞白血病（ALL）患儿中，smn缺乏相关性。患者与方法在多药化疗诱导期和强化期，将205例高危（HR） ALL患儿随机分为单独使用阿霉素组（n = 100）和多柔比星联合右唑嗪组（n = 105）。我们比较了两组中smn的发生率。结果中位随访时间为6.2年，接受右唑嗪治疗组和未接受右唑嗪治疗组的SMNs发生率无差异（P = 0.66）。一例SMN（一种位于颅放射场外的黑色素瘤）发生在一名随机分配单独使用阿霉素的患者身上。在随机分配接受右拉唑烷治疗的患者中未观察到smn。结论右拉唑烷与HR ALL患儿smn风险增加无关。鉴于右razoxane作为心脏保护剂的潜在重要性，我们建议右razoxane继续在含阿霉素的儿科方案中使用和研究。
PurposeDexrazoxane is a drug used to prevent anthracycline-induced cardiotoxicity. A recent report found an association between the use of dexrazoxane and the risk of developing secondary malignant neoplasms (SMNs) in children with Hodgkin's disease. We report the absence of an association of SMNs in children with acute lymphoblastic leukemia (ALL) treated on Dana-Farber Cancer Institute ALL Consortium Protocol 95-01.Patients and MethodsTwo hundred five children with high-risk (HR) ALL were randomly assigned to receive doxorubicin alone (n = 100) or doxorubicin with dexrazoxane (n = 105) during the induction and intensification phases of multiagent chemotherapy. We compared incidence of SMNs in these two groups.ResultsWith a median follow-up of 6.2 years, no differences in the incidence of SMNs were noted between the group that received dexrazoxane and the group that did not (P = .66). One SMN (a melanoma located outside of the cranial radiation field) occurred in a patient who was randomly assigned to doxorubicin alone. No SMNs were observed in patients randomly assigned to receive dexrazoxane.ConclusionDexrazoxane was not associated with an increased risk of SMNs in children treated for HR ALL. Given the potential importance of dexrazoxane as a cardioprotectant, we recommend that dexrazoxane continue to be used and studied in doxorubicin-containing pediatric regimens.