An effective modestly intensive re‐induction regimen with bortezomib in relapsed or refractory paediatric acute lymphoblastic leukaemia

Summary This trial explored the efficacy of re‐induction chemotherapy including bortezomib in paediatric relapsed/refractory acute lymphoblastic leukaemia. Patients were randomized 1:1 to bortezomib (1.3 mg/m2/dose) administered early or late to a dexamethasone and vincristine backbone. Both groups...

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Bibliographic Details
Published in:British journal of haematology 2018-05, Vol.181 (4), p.523-527
Main Authors: Kaspers, Gertjan J. L., Niewerth, Denise, Wilhelm, Bram A. J., Scholte‐van Houtem, Peggy, Lopez‐Yurda, Marta, Berkhof, Johannes, Cloos, Jacqueline, de Haas, Valerie, Mathôt, Ron A., Attarbaschi, Andishe, Baruchel, André, de Bont, Eveline S., Fagioli, Franca, Rössig, Claudia, Klingebiel, Thomas, De Moerloose, Barbara, Nelken, Brigitte, Palumbo, Giuseppe, Reinhardt, Dirk, Rohrlich, Pierre‐Simon, Simon, Pauline, Stackelberg, Arend, Zwaan, Christian Michel
Format: Article
Language:English
Subjects:
acute leukaemia
Acute lymphoblastic leukemia
Bortezomib
Cerebrospinal fluid
Chemotherapy
childhood leukaemia
Dexamethasone
Hematology
Leukemia
Neutropenia
Pain
Patients
pharmacokinetics
proteasome inhibitor
Remission
Toxicity
Vincristine
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Summary:Summary This trial explored the efficacy of re‐induction chemotherapy including bortezomib in paediatric relapsed/refractory acute lymphoblastic leukaemia. Patients were randomized 1:1 to bortezomib (1.3 mg/m2/dose) administered early or late to a dexamethasone and vincristine backbone. Both groups did not differ regarding peripheral blast count on day 8, the primary endpoint. After cycle 1, 8 of 25 (32%) patients achieved complete remission with incomplete blood count recovery, 7 (28%) a partial remission and 10 had treatment failure. Most common grade 3–4 toxicities were febrile neutropenia (31%) and pain (17%). Bortezomib was safely combined with vincristine. Bortezomib rarely penetrated the cerebrospinal fluid.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.15233