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Iguchi A, Cho Y, Sugiyama M, Terashita Y, Ariga T, Hosoya Y, Hirabayashi S, Manabe A, Hara K, Aiba T, Shiokawa T, Tada H, Sato N. Bortezomib combined with standard induction chemotherapy in Japanese children with refractory acute lymphoblastic leukemia. Int J Hematol 2017; 106:291-298. [PMID: 28401497 DOI: 10.1007/s12185-017-2235-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/31/2017] [Accepted: 04/04/2017] [Indexed: 01/02/2023]
Abstract
Bortezomib has been shown to be effective and well-tolerated in patients with refractory acute lymphoblastic leukemia (ALL) in the Therapeutic Advances in Childhood Leukemia trial. However, the safety and efficacy of bortezomib have not been evaluated in Japanese pediatric patients. Here, we report the results of a clinical trial designed to evaluate the safety of bortezomib combined with induction chemotherapy in Japanese children with refractory ALL. A total of six patients with B-precursor ALL were enrolled in this study. Four-dose bortezomib (1.3 mg/m2/dose) combined with two standard induction chemotherapies was used. Prolonged pancytopenia (grade 4) was observed in all patients. Four of the six patients developed severe infectious complications. Peripheral neuropathy (grade 2) occurred in five patients. The individual plasma bortezomib concentration-time profiles were not related to toxicity and efficacy. Five patients were evaluable for response, and four patients achieved complete response (CR) or CR without platelet recovery (80%). In conclusion, four-dose bortezomib (1.3 mg/m2/dose) combined with standard re-induction chemotherapy was associated with a high risk of infectious complications induced by prolonged neutropenia, although high efficacy has been achieved for Japanese pediatric patients with refractory ALL. Attention must be given to severe infectious complications when performing re-induction chemotherapy including bortezomib.
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Affiliation(s)
- Akihiro Iguchi
- Department of Pediatrics, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8638, Japan.
| | - Yuko Cho
- Department of Pediatrics, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8638, Japan
| | - Minako Sugiyama
- Department of Pediatrics, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8638, Japan
| | - Yukayo Terashita
- Department of Pediatrics, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8638, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8638, Japan
| | - Yosuke Hosoya
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | | | - Atsushi Manabe
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Keisuke Hara
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tetsuya Aiba
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tsugumi Shiokawa
- Department of Instrumental Analysis Advanced Science Research Center, Okayama University, Okayama, Japan
| | - Hiroko Tada
- Department of Instrumental Analysis Advanced Science Research Center, Okayama University, Okayama, Japan
| | - Norihiro Sato
- Department of Clinical Research & Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
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