Daunorubicin therapy in advanced neuroblastoma

Forty-three children with advanced, disseminated neuroblastoma were treated with regimens of Daunorubicin (Daunomycin) 1 mg/kg every other day (QOD) or daily, with total doses of 3-10 mg/kg/course of treatment, usually repeated monthly. There was objective response in only 28% of all children treated, although those receiving drug daily showed 40% partial responses, compared with 11% partial responses in those receiving the drug QOD. Subjective responses approached 70%. Toxicity, usually severe leukopenia and thrombocytopenia, was present in the majority of the children who received adequate therapy. There were 3 deaths from sepsis. It is recommended that while Daunorubicin may be used for patients with advanced neuroblastoma who no longer respond to more effective agents, it should be investigated at lower doses in combination with other drugs and probably used earlier in the course of disease.