Difference between revisions of "Chronic myeloid leukemia, pediatric"
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=Guidelines= | =Guidelines= | ||
=AAML0123= | =AAML0123= | ||
+ | ==Stratum 1, 2, or 3== | ||
+ | ===Chemotherapy=== | ||
+ | *[[Imatinib (Gleevec)]] 340 mg/m<sup>2</sup> PO rounded to the nearest 100 mg once daily. | ||
+ | *Patient evaluated per protocol after each 28 day cycle for response and toxicities. | ||
+ | *Hold [[Imatinib (Gleevec)]] if a grade 2 nonhematologic adverse event fails to resolve or if a grade 3 or 4 nonhematologic adverse event occurs. | ||
+ | *After resolution to < grade 1, [[Imatinib (Gleevec)]] dose may be reduced by 30%. | ||
+ | *[[Imatinib (Gleevec)]] therapy continued until completion of 13 28-day courses (1 year). | ||
+ | '''28-Day Course''' | ||
+ | ===References=== | ||
+ | #'''COG AAML0123:''' Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Copoley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, SMith FO, Bernstein ML. Higher Dose Imatinib for Children with De NoVo Chronic Phase Chronic Myelogenous Leukemia: A Report from the Children's Oncology Group. Pediatr Blood Cancer 2011 Jul 15;57(1):56-62. [https://dx.doi.org/10.1002%2Fpbc.23031 link to original article] '''contains verified protocol''' NCT00030394 | ||
+ | ==Stratum 4== | ||
+ | ===Chemotherapy=== | ||
+ | *[[Imatinib (Gleevec)]] 570 mg/m<sup>2</sup>/day PO divided BID rounded to the nearest 100 mg (maximum dose of 1000 mg/day). | ||
+ | *Patient evaluated per protocol after each 28 day cycle for response and toxicities. | ||
+ | *Hold [[Imatinib (Gleevec)]] if a grade 2 nonhematologic adverse event fails to resolve or if a grade 3 or 4 nonhematologic adverse event occurs. | ||
+ | *After resolution to < grade 1, [[Imatinib (Gleevec)]] dose may be reduced by 30%. | ||
+ | *[[Imatinib (Gleevec)]] therapy continued until completion of 13 28-day courses (1 year). | ||
===References=== | ===References=== | ||
#'''COG AAML0123:''' Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Copoley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, SMith FO, Bernstein ML. Higher Dose Imatinib for Children with De NoVo Chronic Phase Chronic Myelogenous Leukemia: A Report from the Children's Oncology Group. Pediatr Blood Cancer 2011 Jul 15;57(1):56-62. [https://dx.doi.org/10.1002%2Fpbc.23031 link to original article] '''contains verified protocol''' NCT00030394 | #'''COG AAML0123:''' Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Copoley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, SMith FO, Bernstein ML. Higher Dose Imatinib for Children with De NoVo Chronic Phase Chronic Myelogenous Leukemia: A Report from the Children's Oncology Group. Pediatr Blood Cancer 2011 Jul 15;57(1):56-62. [https://dx.doi.org/10.1002%2Fpbc.23031 link to original article] '''contains verified protocol''' NCT00030394 | ||
− | |||
=="How I Treat"== | =="How I Treat"== | ||
*'''2019:''' Hijiya & Suttorp [http://www.bloodjournal.org/content/133/22/2374.long How I treat chronic myeloid leukemia in children and adolescents] | *'''2019:''' Hijiya & Suttorp [http://www.bloodjournal.org/content/133/22/2374.long How I treat chronic myeloid leukemia in children and adolescents] |
Revision as of 08:03, 7 October 2021
Section editor transclusions This page contains studies that were specific to pediatric populations. For the more general CML page, follow this link.
6 regimens on this page
7 variants on this page
|
Guidelines
AAML0123
Stratum 1, 2, or 3
Chemotherapy
- Imatinib (Gleevec) 340 mg/m2 PO rounded to the nearest 100 mg once daily.
- Patient evaluated per protocol after each 28 day cycle for response and toxicities.
- Hold Imatinib (Gleevec) if a grade 2 nonhematologic adverse event fails to resolve or if a grade 3 or 4 nonhematologic adverse event occurs.
- After resolution to < grade 1, Imatinib (Gleevec) dose may be reduced by 30%.
- Imatinib (Gleevec) therapy continued until completion of 13 28-day courses (1 year).
28-Day Course
References
- COG AAML0123: Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Copoley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, SMith FO, Bernstein ML. Higher Dose Imatinib for Children with De NoVo Chronic Phase Chronic Myelogenous Leukemia: A Report from the Children's Oncology Group. Pediatr Blood Cancer 2011 Jul 15;57(1):56-62. link to original article contains verified protocol NCT00030394
Stratum 4
Chemotherapy
- Imatinib (Gleevec) 570 mg/m2/day PO divided BID rounded to the nearest 100 mg (maximum dose of 1000 mg/day).
- Patient evaluated per protocol after each 28 day cycle for response and toxicities.
- Hold Imatinib (Gleevec) if a grade 2 nonhematologic adverse event fails to resolve or if a grade 3 or 4 nonhematologic adverse event occurs.
- After resolution to < grade 1, Imatinib (Gleevec) dose may be reduced by 30%.
- Imatinib (Gleevec) therapy continued until completion of 13 28-day courses (1 year).
References
- COG AAML0123: Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Copoley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, SMith FO, Bernstein ML. Higher Dose Imatinib for Children with De NoVo Chronic Phase Chronic Myelogenous Leukemia: A Report from the Children's Oncology Group. Pediatr Blood Cancer 2011 Jul 15;57(1):56-62. link to original article contains verified protocol NCT00030394
"How I Treat"
- 2019: Hijiya & Suttorp How I treat chronic myeloid leukemia in children and adolescents
Chronic phase, first-line therapy
Imatinib monotherapy
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Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Champagne et al. 2011 (COG AAML0123) | 2002-2004 | Phase II (RT) |
Targeted therapy
- Imatinib (Gleevec) 340 mg/m2 PO once per day
28-day cycles
References
- COG AAML0123: Champagne MA, Fu CH, Chang M, Chen H, Gerbing RB, Alonzo TA, Cooley LD, Heerema NA, Oehler V, Wood C, French ME, Arceci RJ, Smith FO, Bernstein ML. Higher dose imatinib for children with de novo chronic phase chronic myelogenous leukemia: a report from the Children's Oncology Group. Pediatr Blood Cancer. 2011 Jul 15;57(1):56-62. Epub 2011 Apr 4. link to original article link to PMC article contains protocol PubMed NCT00030394
Nilotinib monotherapy
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Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Hijaya et al. 2019 (DIALOG) | 2013-2015 | Phase II (RT) |
Targeted therapy
- Nilotinib (Tasigna) 230 mg/m2 PO twice per day
Continued indefinitely
References
- DIALOG: Hijiya N, Maschan A, Rizzari C, Shimada H, Dufour C, Goto H, Kang HJ, Guinipero T, Karakas Z, Bautista F, Ducassou S, Yoo KH, Zwaan CM, Millot F, Aimone P, Allepuz A, Quenet S, Hourcade-Potelleret F, Hertle S, Sosothikul D. Phase 2 study of nilotinib in pediatric patients with Philadelphia chromosome-positive chronic myeloid leukemia. Blood. 2019 Dec 5;134(23):2036-2045. link to original article contains verified protocol link to PMC article PubMed NCT01844765
Chronic phase, relapsed or refractory
Dasatinib monotherapy
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Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Gore et al. 2018 (CA180-226) | 2009-2014 | Phase II (RT) |
Targeted therapy
- Dasatinib (Sprycel) 60 mg/m2 PO once per day
Continued indefinitely
References
- CA180-226: Gore L, Kearns PR, de Martino Lee ML, De Souza CA, Bertrand Y, Hijiya N, Stork LC, Chung NG, Cardos RC, Saikia T, Fagioli F, Seo JJ, Landman-Parker J, Lancaster D, Place AE, Rabin KR, Sacchi M, Swanink R, Zwaan CM. Dasatinib in Pediatric Patients With Chronic Myeloid Leukemia in Chronic Phase: Results From a Phase II Trial. J Clin Oncol. 2018 May 1;36(13):1330-1338. Epub 2018 Mar 2. link to original article link to PMC article contains verified protocol PubMed NCT00777036
Nilotinib monotherapy
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Regimen
Study | Years of enrollment | Evidence |
---|---|---|
(CAMN107A2120) | 2011-NR | Phase 1, <20 pts (RT) |
Note: there is no obvious publication of this trial.
Targeted therapy
References
- CAMN107A2120: NCT01077544