Pentoxifylline during steroid window phase at induction to remission increases apoptosis in childhood with acute lymphoblastic leukemia

• O. Gonzalez-Ramella ^[1] ; P. C. Ortiz-Lazareno ^[2] ; X. Jiménez-López ^[1] ; S. Gallegos-Castorena ^[1] ; G. Hernández-Flores ^[2] ; F. Medina-Barajas ^[1] ; J. Meza-Arroyo ^[2] ; L. F. Jave-Suárez ^[2] ; J. M. Lerma-Díaz ^[2] ; F. Sánchez-Zubieta ^[1] ; A. Bravo-Cuellar ^[2]
  1. [1] Universidad de Guadalajara

     Universidad de Guadalajara

     México

     
  2. [2] Instituto Mexicano del Seguro Social

     Instituto Mexicano del Seguro Social

     México

     
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 18, Nº. 4 (April 2016), 2016, págs. 369-374
• Idioma: inglés
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• Resumen

  • Purpose Pentoxifylline (PTX) has been shown to increase chemotherapy-induced apoptosis. A clinical trial was developed to evaluate the effect of the addition of PTX to the induction steroid window phase in children with acute lymphoblastic leukemia (ALL).

    Methods Thirty-two children were enrolled on this study. Children with a new diagnosis of ALL were randomly assigned to receive prednisone (PRD) 40 mg/m2/day only during the 7-day treatment pre-phase (PRD group, 11 patients) or to receive PRD with PTX (10 mg/kg/day) (PTX group, 11 patients); the control group included children with normal bone marrow (10 patients). Bone marrow aspiration (BMA) was performed at diagnosis (day −7) in all groups, and at day 0 (end of PRD window) for patients with ALL (PRD and PTX groups). Apoptosis was evaluated by flow cytometry (FC) using Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) stains. Statistical analysis was performed using the Mann–Whitney U test.

    Results Apoptotic index at day −7 was similar in all groups. However, at day 0 post-treatment, apoptosis was significantly higher in the PTX group than in the PRD group (p < 0.001). There were no serious adverse effects associated with PTX.

    Conclusions PTX potentiates blast apoptosis induced by PRD in children with ALL during steroid window phase.