Abstract
We have employed continuous chemotherapy consisting of etoposide 30 mg/m2/day and cytarabine20 mg/m2/day (low dose VP + CA) for the treatment of pediatric patients since March, 2002. The aims were cytoreduction to prevent tumor lysis syndrome or for refractory leukemia against standard chemotherapy, reduction of leukemic cell burden for refractory leukemia as a part of conditioning regimen for stem cell transplantation (SCT), and ensuring engraftment in SCT for non-malignant diseases. We evaluated 35 patients (a total of 52 courses of this therapy). 27 patients had refractory leukemia, including 17 with acute myeloid leukemia (AML) and 10 with acute lymphoblastic leukemia (ALL). Eight patients had other conditions. Disappearance of leukemic cells from peripheral blood was observed in 32 out of 46 courses for the first aim and in 13 out of 16 courses for the second aim. The reduction rate of white blood cells was 88.3% in a total of six courses for the third aim. Mild adverse events such as stomatitis were observed in eight courses (15.3%). We concluded that low dose VP + CA is useful in making time and slow cytoreduction before intensified chemotherapy or SCT.
