Bone marrow transplantation
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Bone Marrow Transplant. · Oct 2008
Review Clinical TrialPharmacokinetics of high-dose i.v. treosulfan in children undergoing treosulfan-based preparative regimen for allogeneic haematopoietic SCT.
Pharmacokinetic studies of high-dose treosulfan were carried out in seven paediatric patients (age range: 2-15 years) undergoing treosulfan-based conditioning regimen prior to allogeneic haematopoietic SCT. Treosulfan was administered intravenously in a daily dose of 10, 12 or 14 g/m(2) within 2 h. Five out of seven patients received 12 g/m(2). ⋯ The results of this study confirmed the linear pharmacokinetics of treosulfan, as used in children. However, variability of pharmacokinetic results observed in children studied demonstrates the need for pharmacokinetic evaluation in each paediatric patient undergoing the treosulfan-based preparative regimen, including those using different doses. This approach could enable further reduction of the risk of early and late organ toxicity related to high-dose treosulfan in paediatric patients.
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Bone Marrow Transplant. · Oct 2008
Review Comparative StudyWhere should adolescents with ALL be treated?
Currently, 50% of adolescents with ALL are treated by adult teams and 50% by paediatric teams (following either adult or paediatric protocols). The aim of this paper is to review the results obtained with first-line chemotherapy and with haematopoietic SCT (HSCT) in adolescents with ALL. Disease biology and host factors are responsible for the differences observed between adolescents and other age categories. ⋯ Cooperation between paediatric and adult haematologists would surely improve the ability to recruit as many patients as possible and would promote progress in the research on adolescents. In conclusion, redefining age limits according to risk-based strategies, as well as encouraging multi-centre cooperation, should be taken into consideration to improve the outcome of this age category. Adolescents should be referred to research treatment teams that have experience in the management of paediatric ALL and they should be enrolled in international cooperative studies.