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document
Low-dose oral etoposide-based induction regimen for children with acute lymphoblastic leukemia in first bone marrow relapse . We evaluated the clinical response to low-dose etoposide in relapsed acute lymphoblastic leukemia ( ALL ) . Of the 45 patients with ALL in first bone marrow relapse enrolled on the ALL R15 protocol , 44 had received epipodophyllotoxins during frontline therapy . In the first week of remission induction therapy , patients received etoposide ( 50 mg/m ( 2 ) per day ) administered orally as a single agent once or twice daily . On Day 8 , patients started to receive dexamethasone , vincristine , and L-asparaginase . Etoposide was administered until Day 22 . Two courses of consolidation therapy were followed by continuation therapy or hematopoietic stem cell transplantation . After 7 days of single-agent etoposide treatment , peripheral blast cell counts ( P=0.013 ) and percentages of bone marrow blasts ( P=0.016 ) were significantly reduced . In all , 38 ( 84.4 % ) attained second remission . Only time to relapse was significantly associated with outcome ( P=0.025 ) : the 5-year event-free survival estimates ( +/-se ) were 52.0+/-9.6 % for those with late relapse and 20.0+/-8.0 % for those with early relapse . We conclude that low-dose etoposide administered orally has a cytoreductive effect in relapsed ALL .
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Intervention_Pharmacological
Low-dose oral etoposide-based
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Intervention_Pharmacological
low-dose etoposide
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Intervention_Pharmacological
epipodophyllotoxins during frontline therapy .
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Intervention_Pharmacological
etoposide
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Intervention_Pharmacological
dexamethasone , vincristine , and L-asparaginase
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Intervention_Pharmacological
Etoposide
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Intervention_Physical
continuation therapy
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Intervention_Physical
hematopoietic stem cell transplantation
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Intervention_Pharmacological
low-dose etoposide
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Outcome_Physical
clinical response
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Outcome_Physical
peripheral blast cell counts
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Outcome_Physical
percentages of bone marrow blasts
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Outcome_Physical
second remission .
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Outcome_Other
time to relapse
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Outcome_Mortality
5-year event-free survival
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Participant_Age
children
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Participant_Condition
acute lymphoblastic leukemia
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Participant_Condition
acute lymphoblastic leukemia
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Participant_Condition
ALL
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Participant_Sample-size
45