Background: T-cell malignancies in childhood are highly malignant diseases usually treated with intensive multidrug chemotherapy. In these regimens, anthracyclines, which are considerably cardiotoxic, are used. Mitoxantrone is structurally related to the anthracyclines, but it is considered to be less cardiotoxic. Therefore, the effectiveness of mitoxantrone in treating childhood T-cell malignancies was studied.
Methods: Fourteen newly diagnosed children with T-cell malignancies (12 T-cell non-Hodgkin's lymphoma, 2 T-cell acute lymphoblastic leukemia) initially were treated with one bolus injection of mitoxantrone, 12 mg/m2 intravenously, 1 week before standard induction therapy was begun. The effect of mitoxantrone was evaluated at Day 8, just before standard induction therapy was begun.
Results: Of 12 evaluable patients, 11 had significant positive responses with regard to the size of the primary tumor, the size of the involved peripheral lymph nodes, and the presence of lymphoblasts in the peripheral blood. The toxicity of mitoxantrone was mild.
Conclusions: Mitoxantrone is effective in treating childhood T-cell malignancies. Its efficacy needs to be compared with the anthracyclines in a future randomized study.