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Main description:
The dramatic improvement made in recent years in the treatment of child hood malignancies has been in large part the result of advances in the field of pharmacology. Chemotherapy is the major therapeutic modality used to treat childhood cancer. Rational administration of antineoplastic chemo therapy to the child with cancer requires the pediatric oncologist to have a thorough understanding of the fundamental principles of clinical pharmaco logy, an intimate knowledge of the specific agents being used, and an aware ness of the unique biologic and physiologic features of children. In mid 1985, a distinguished group of pediatric oncologists and clinical pharmacologists convened in a unique workshop to review the subject of pharmacology in pediatric oncology. A goal of this workshop was to pro duce a book which would review this topic and present it in a format useful for the clinician. In this book basic principles of pharmacology, mechanisms of drug resis tance, new methods of drug delivery, guidelines for studying new agents in children, new biological response modifiers and the pharmacology of the most commonly used chemotherapeutic agents in children are reviewed in depth. Particular emphasis is given to discussing those topics which unique ly apply to the use of antineoplastic agents in children with cancer. The Editors VII Contents Preface . v Contents Vll List of Major Contributors Xl Principles of Antineoplastic Therapy in Children 1. Clinical pharmacokinetics for the pediatric oncologist ................ .
Contents:
Principles of Antineoplastic Therapy in Children.- 1. Clinical pharmacokinetics for the pediatric oncologist.- 2. The pharmacology of antineoplastic agents in children.- 3. Clinical pharmacology of anticancer drugs in children: differences and similarities between children and adults.- Pharmacologic reasons for treatment failure.- 4. Drug resistance in medical and pediatric oncology.- 5. Genetic reasons for pharmacologic treatment failure: gene amplification.- 6. New approaches to overcome drug resistance.- Methods of drug delivery.- 7. New methods of administering old drugs: iv infusion of mercaptopurine.- 8. Regional therapy: an overview.- 9. Pharmacologic approaches to the treatment of central nervous system malignancy.- Use of new agents in children.- 10. Phase I and II trials in pediatric cancer patients: a rationale.- 11. Guidelines for conduct of Phase I studies in children.- Pharmacology of antileukemic agents.- 12. Factors affecting the clinical pharmacology of antileukemic drugs.- 13. Potentiation of 6-mercaptopurine after time and dose-dependent pretreatment with methotrexate in malignant human T- and B-lymphoblasts.- 14. The effect of methotrexate on purine and pyrimidine deoxyribonucleoside triphosphate pools and on cell viability and cell-phase distribution in malignant human T- and B-lymphoblasts.- 15. 7-Hydroxy-methotrexate production after methotrexate therapy.- Late effects of chemotherapy.- 16. An overview of adverse late effects of cancer chemotherapy in children.- 17. Focusing on late effects in long-term survivors of childhood leukemia and lymphomas.- High dose chemotherapy.- 18. Purging procedures: a critical step in autologous bone marrow transplantation.- 19. 'High dose' cisplatinum: a phase II study.- Biological response modifiers.- 20. Induction of differentiation: a possible therapeutic approach to the treatment of hematologic malignancy.- 21. The development of 9-substituted purines as immunomodulators.- 22. Immunopharmacologic profile of an L-Arginine hypoxanthine dervative: PCF/01.- 23. Antineoplastic drugs modulating c-myc expression in K562, induce erythroid differentiation and modify, with IFN, susceptibility to NK cell mediated lysis.- 24. In vivo treatment with recombinant interleukin-2 (IL-2) stimulates the differentiation of natural killer (NK) precursor cells.- 25. Immunopharmacology studies related to in vitro infection with HTLV-I.
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