Thankyou for all your hard work compiling this
@wombat777, this is very generous of you always .
You deserve way more pats on the back
There is something that really blew my mind when I learned of the facts , re bone marrow transplants , availability after Bisantrene induced remissions in the children , in at least one of these case histories -
This was the study in the early 1990s and I ‘m now presuming was likely and the usual sad situation even more for the the case study back in 1984 !
**** Bone marrow transplants ( doner found ) were more rare — almost an impossibility, or , very
low probability if not matched and possible from absolute immediate family for
most leukaemia patients . I think, back when these trials were performed historically *
We have forgotten .
This blew me away to remember
I think that only a few children in each of these studies - ever got the amazing gift of a bone marrow transplant,
Eg: In these studies - 2 out of 12 ? kids who had entered CR after Bisantrene treatment for relapsed / R AML . Got a bone marrow transplant-
the rest missed out !
They were very sick to begin with, pre- treated a lot before final relapsing again - very acute Relaxed / refractory Acute amyloid leukaemia, unable tolerate existing other chemotherapy again or anything - and then Bisantrene given . They turned and went into CR again .
***But without a bone marrow successful transplant - no one can survive this disease. ***
This is leukaemia. And — It is terrible .
To survive this - these cases above , full cures after all - are absolutely remarkable.
***But more may well have been cured - Saved ! even -
if
a bone marrow transplant could have been suitably matched & had been a success .
They never received a bone marrow transplant opportunity- and so they died after all they had endured , even after CR responses .
A Bone marrow transplant is Essential. For survival . This is a long time ago - and among all - the fact of this - That no bone marrow transplant was able fo be received , sadly- makes Bisantrene even more exciting , and tear- inducing really !
*No wonder the original doctor , in France where Bisantrene was approved for R/R AML — has followed these young girls now women
all of their lives since- their Cure.
It is such a very real miracle but compelling for Bisantrene- that there was this wonderful confluence of :Bisantrene in there saving them from the brink .
And - availability of a bone marrow transplant. For context :
I recall - empassioned pleas , stories shared in women’s magazines ,
international searches for a bone marrow match - in time ,. before the patient, or little child frequently died . A national bone marrow register being set up .
Information about the lifesaving stories that were possible if sick people,
many of them children, received a doner marrow in time ., most died waiting .
There were huge advertising awareness campaigns for people , to have their tissue- typing done , and be placed on what was the new International tissue register , and perhaps if in an extreme rare case , proved to be a match, could make an enormous difference and save someone’s life in say America , here in Australia or wherever .
But they needed people to register .
Some people’s chances are way higher for a match - not too rare a tissue type .
Others- so rare .
The proverbial needle in haystack if noone in immediate family - 1/ thousands instead of 1/ hundreds .
Not uncommon that your match , or a suitable marrow match be in the USA and you a patient in Australia.
They needed get thousands more people on the register for all the medical possibilities to be successful - or could not save the very sick leukaemia patients anyway .
(There was not infrequently- fundraising , radio talkback , local campaigns; to try send a child to the US before they died , their mother go with them if very young - but all required money and they had to wait for doner persons marrow to be ready and then able receive transplant . Full permissions gone through , this all ‘If ‘ they could survive this long . Many or most times -not .)
So in these historical trial studies - clearly where no tissue match could be found or achieved from the leukaemia sufferers immediate family. No hope in then end . Only 2 children received in the study .
(Most bone marrow transplant doners were luckiest if - a parent , or sibling , or grandparent tested and matched
If not - then a wider family search if family members were willing .
Doner providers had to understand and have empathy and believe that their donation , extremely painful and complex process to travel to hospital treatment location , be pre- treated, & their bone marrow sourced in itself also a very complicated and emotional thing, was something they would do . )
And I think suddenly we can all remember and have more idea of this fact, only a few received transplants in context of the few children who survived that known , yet many entered CR .
** It also makes more sense -Why ! : bisantrene was “lost “ , sac in dropped / and lost ** in early 90s with shenigans of Lederle being taken over in america .
I would like to ask a question also of
@RaceOncology -
Please if you can comment on cytarabine ?
How may it compare -toxicity wise obviously , but in broad application, and if any issues or features about it as chemotherapeutic drug of note ?
(in AML is fairly standard ? Chemotherapy drug at present )
Thankyou
(20min delay)