LOW-DOSE CONTINUOUS-INFUSION DOXORUBICIN IN CHILDREN AND YOUNG-ADULTS

Ten patients (age range 3.2-26.3 yrs) with relapsed or resistant malig nancies received a total of 20 courses of low dose continuous infusion doxorubicin (3 mg/m2/day for 28 days) delivered by portable Graseby i nfusion pumps via central venous catheters. Each patient received a me dian dose of 144 mg/m2 (range 87-261). Four patients responded to trea tment (1 complete response (CR) and 3 partial response (PR)) and perfo rmance status improved in seven patients. Overall toxicity was minimal : WHO Grade 4 anaemia in 2/18 courses, Grade 4 neutropenia in 1/18, Gr ade 3-4 thrombocytopenia in 3/18, nausea and vomiting of Grades 2 and 4 in 4/20 and 1/20 respectively, and mucositis of Grades 2 and 4 in 2/ 20 courses each. Cardiac toxicity was assessed using echocardiography, and fractional shortening remained within normal limits in all patien ts. Low dose continuous infusion doxorubicin is a feasible, well toler ated, ambulatory therapy in children and may be an effective way of de livering doxorubicin with less toxicity, thus enabling the development of more dose intensive regimens. (C) 1993 Wiley-Liss, Inc.