Wow - truth . ( “cheap”)
Thankyou so much for answering
@race .
My heart skipped a beat letting this sink in .
Basically -
The patients were extremely sick .
Heavily pretreated - with standard lines of care for AML and Leukaemia .
Relapsed ; or non - responsive - Refractory AML .
Very ill and soon going to die .
Anthracyclines, cause much harm , especially to the heart - weakening (the left side of heart ) , toxic to and causing permanent cardiac muscle damage , so that the heart then can’t contract properly and tries to work harder and the lungs can’t get the volume of oxygen into the heart that is needed to be pumped around - leads to overwork of the residual heart & heart failure with time .
For patients who survive the overall treatment and the cancer - heart damage leaves them on high blood pressure medications, and breathless with any activity , things they used to do with ease & without any concern .
especially- in women , and
- * very acute effects in children, of heart damage . Kills them even as hearts underdeveloped. ( Typical Anthracyclines - ‘standard’ chemotherapeutic drugs. Bisantrene differs in not being toxic to the heart and less toxicity overall , ‘remarkably low toxicity ‘ says Dr Cullity , and much more relative safety from past known use )
Elderly patients.
Patients with Co- morbidities or frailty , physically weak , or ,
children -cannot tolerate Anthracyclines , really not at all . This we all know .
But I’m seeing now these historical bisantrene trials in reality- facts are Much more compelling !
Where no hope existed- given in these clinical trials and 40 other clinical trials .
Plus bisantrene had been approved in France for R/R AML ( was Lederle’s drug )
So - in over 40 clinical trials , was known to be relatively safe ,
low toxicity - and was studied in R/R in dire cases inc AML as in these studies above, given to very sick children who by this stage had no other hope, and were near to dying from the leukaemia
@wombat777.
Seeing now -
**without an exact match doner ( sibling ) -there was still no possibility of bone marrow transplant nor of survival . Ultimately . Most likely .
** So many of these kids entered CR !
Such a large percentage!
Theoretically they had gained chance of surviving the AML ... but
in actual fact - while enduring all the trauma of their child’s acute illness and the desperate fight for chance to beat the AML & survive - these parents will actually have known , or
not, . - if their child had ultimately No chance .
** It becamenot unusual for parents to decide to have another baby even - ie. try to fall pregnant at once- and go through leukaemia treatment fight with their sick child , if basically their newborn baby could be a 3/4 chance ? of being a suitable match doner ? ( or they had a new baby and lost their sick child if no match or not in time !)
“Sisters Keeper “ style .
Its not a wonder at all - bisantrene- full chances for cure
of more of these children though achieved a Complete respondents from bisantrene - was still greater hurdle if no bone marrow match , back 30 years ago .
Parents - will already have known , or it would fully have reached the cruel realisation and had to accept and prepare their child - already by after the bisantrene even where CR if likely going to die .
No hope it no brother or sister doner , even so child then had to survive the more fraught historical process of marrow transplant back then .
Tragic.
Thankyou so much Dr T .
No wonder you are all working so hard on this - bring back bisantrene.
It should also be much better now in this modern era .
Way more useful and I agree with
@oze - bring it in as early as possible in treatment if the cancer is susceptible.
(20min delay)