A study of toxicity and comparative therapeutic efficacy of vindesine-prednisone vs. vincristine-prednisone in children with acute lymphoblastic leukemia in relapse - A Pediatric Oncology Group study

Tribhawan Vats, George Buchanan, Paulette Mehta, Abdal Ragab, Eva Hvizdale, Ruprecht Nitschke, Michael Link, G. Peter Beardsley, David Maybee, Jeffrey Krischer

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Vindesine (des-acetyl Vinblastine) is a synthetic derivative of vinblastine, and was produced with the hope that it would have less neurotoxicity and hematopoietic toxicity than other vinca alkaloids. Phase I and II studies also demonstrated significant activity in lymphoid malignancies, especially Acute Lymphoblastic Leukemia (ALL). The present study was designed to compare therapeutic effectiveness of twice weekly vindesine (2 mg/M2/dose) plus Prednisone (60 mg/M2/dose) (Treatment 1) to weekly Vincristine (2 mg/M2/dose) plus Prednisone (60 mg/M2/day) (Treatment 2). All patients were less than 21 years of age, and had documented bone marrow relapse (blast count>25%). In 39 patients presumed sensitive to vincristine, there were 11 complete responses out of 20 patients (55%) randomized to receive vindesine/ prednisone and 7 complete responses out of 19 patients (37%) treated with Vincristine/Prednisone. In 37 patients resistant to vincristine, there were 7 complete responses (19%). Vindesine was more toxic than Vincristine. Major toxicities of vindesine included paraesthesias, peripheral neuropathy and ileus. Vindesine hematological toxicity appeared greater, but such toxicity is hard to assess in patients with bone marrow disease. In this study, vindesine and vincristine had similar efficacy, but vindesine use was associated with more toxicity.

Original languageEnglish (US)
Pages (from-to)231-234
Number of pages4
JournalInvestigational New Drugs
Volume10
Issue number3
DOIs
StatePublished - Aug 1992

Keywords

  • acute lymphoblastic leukemia
  • relapse
  • vincristine
  • vindesine

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

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