TOTAL-BODY HYPERTHERMIA IN COMBINATION WITH ETOPOSIDE AND MELPHALAN IN A CHILD WITH ACUTE MYELOMONOCYTIC LEUKEMIA

In vitro and clinical studies have shown antineoplastic effects of hyp erthermia alone and in combination with other treatment modalities. Sy nergistic cytotoxic effects of chemotherapy and hyperthermia have been demonstrated on leukemic cell clones in vitro. It seems that hyperthe rmia is effective in overcoming chemotherapy resistance. Several group s treated solid tumors by using total body hyperthermia (TBHT). Howeve r, only a few studies have been reported investigating the clinical ef fects of TBHT in myeloproliferative disorders. We report the case of a 7-year-old boy with myelomonocytic leukemia treated with TBHT (2 hour s, 42-degrees-C) combined with etoposide (600 mg/m2), melphalan (30 mg /m) and hyperglycemia (200-300 mg/dl). Within 24 hours after TBHT, the leukemic cells decreased after TBHT from 53,000/mul to zero. Skin leu kemic infiltrates, resistant to conventional treatment, also responded well. Although our patient relapsed 34 days after TBHT, these results indicate that TBHT in combination with cytotoxic treatment may be a u seful treatment modality in refractory leukemia. (C) 1994 Wiley-Liss, Inc.