TREATMENT OF CHILDHOOD ACUTE LYMPHOCYTIC LEUKEMIA: DRUG INTERACTIONS AND RISK-BENEFIT RELATIONSHIP IN THE BFM AND GBTLI PROTOCOLS

• DOI: https://doi.org/10.22533/at.ed.813522527027

• Palavras-chave: Lymphocytic leukemia; Onco-hematologic treatment; Interactions; Treatment; GBTLI; BFM; Synergism; Antagonisms.

• Keywords: Lymphocytic leukemia; Onco-hematologic treatment; Interactions; Treatment; GBTLI; BFM; Synergism; Antagonisms.

• Abstract: The treatment of acute lymphoblastic leukemia in children with B and T cells requires specific therapeutic regimens, such as BFM and GBTLI, based on stratified diagnosis according to severity. The objective of the present study was to analyze antineoplastic interactions in relation to safety, the classes employed, and the risks of treatment. A bibliographic review was conducted on specific legislation, books, clinical drug studies, and scientific articles, available in the following databases: LILACS, SCIELO, BIREME, SCIENCE DIRECT, and PUBMED. The beneficial synergistic interactions of daunorubicin, vincristine, prednisolone, and L-asparaginase can be highlighted, as well as antagonistic interactions of vincristine and cytarabine, and cytotoxic effects leading to severe neutropenia, pancreatitis, neural and cardiac cytotoxicity. The BFM protocol obtained a positive response in 70% of cases, compared to 90% positivity with the GBTLI protocol, thus showing that there is a key point between success and failure in treatment, which is the patient's life, and that it requires stratified and accurate diagnosis of the involved cells to guide the best protocol. It is concluded that combined treatment is still the best choice, with positive synergistic interactions in view of the negatives, requiring the use of monoclonal antibodies targeted at remaining malignant cells, based on early diagnosis, corroborating a historical series of success from BFM to GBTLI.