Wilm’s tumour

It is used in choriocarcinoma, Hodgkin s disease and Wilm s tumour in combination with irradiation. 

It is indicated in acute leukaemias, lymphomas, Ewing s sarcoma, neuroblastoma, Wilm s tumour and idiopathic thrombocytopenic purpura. 

Wilm s tumour Endometrial cancer Lov/-grade lymphoma Myeloma Biadder cancer Meianoma Renal cancer Primary brain cancers Nasopharyngeal carcinoma Hepatoma Astrocytoma ... 

Examples (a) Cancerous tumors having high growth fractions which are foimd to give adequate response to chemotherapy are, namely Hodgkin s disease, Burkitt s lymphoma, Wilm s tumour, acute leukemia in children, choriocarcinoma, chronic myelogenous leukemia, lymphocytic leukemia, and breast cancer. 

It is employed for the treatment of acute leukemia in ehildren, neuroblastoma, Wilm s tumour and rhabdomyosarcoma. It is found to induce remission in lymphosarcoma and Hodgkin s disease. It is also used in eombination therapy with daunomycin and prednisone in dramatic remission of leukemia. 

Uracil mustard has undergone quite extensive clinical trials, and has been found effective in the treatment of chronic lymphocytic and granulocytic leukaemias, Hodgkin s disease and lymphosarcoma. Occasionally solid tumours, notably ovarian carcinoma, have responded. Dramatic symptomatic relief is obtained with Hodgkin s disease and multiple myeloma, and the drug is well tolerated [491-496]. It is not effective in acute granulocytic leukaemia [491], in acute leukaemia of children [497], or metastatic Wilm s tumour [498]. It is of limited usefulness with rare neoplasms in children [499]. Gastrointestinal disturbances, leukopaenia, and thrombocytopaenia are often noted in patients under treatment with uracil mustard. It is less toxic than cyclophosphamide (cytoxan) [500]. 

Dactinomycin, or actinomycin D as it was called when first introduced, has shown striking curative properties in Wilms s tumour of the kidney which forms a high proportion of all malignant tumours in children. Under its influence, even pulmonary metastases caused by this tumour regress (Farber and Mitus, 1968). Forms of cancer requiring longer treatment are not suitable for this drug, which has only moderate selectivity. 

Actinomycin D finds application in the treatment of Wilm s tumour [324, 325], trophoblastic tumours [326, 327], rhabdomyosarcoma [328, 329] and cancer of the testes and uterus [330, 330a]. It produces chealitis and ulceration in the mouth, anorexia, nausea, vomiting, abdominal pains, diarrhoea. 

Pritchard-Jones K, Fleming S, Davidson D, et al. The candidate Wilms tumour gene is involved in genitourinary development. Nature. 1990 346 194-197. 

Chatles AK, Mall S, Watson J, et al. Expression of the Wilms turnout gene WTl in the developing human and in paediatric renal tumours an immunohistochemical study. Mol Pathol. 1997 50 138-144. 

Doxorubicin [10 ] 1982 Acute lymphoblastic leukaemia, Acute myeloblastic leukaemia, Wilms tumour, neuroblastoma Soft tissue and bone sarcomas Breast carcinoma Ovarian carcinoma Transitional cell bladder carcinoma Thyroid carcinoma Gastric carcinoma Hodgkin s disease Malignant lymphoma Bronchogenic carcinoma 60-75 mg/m IV 21 day intervals as monotherapy 40-60mg/m2 IV 21-28day intervals in combination therapy Max recommended cumulative dose 450-500mg/m ... 

Ng YY, Healy JC, Vincent JM et al (1994) The radiology of non-Hodgkin s lymphoma in childhood a review of 80 cases. Clin Radiol 49(9) 594-600 Ora I, van Tinteren H, Bergeron C et al (2007) Progression of localised Wilms tumour during preoperative chemotherapy is an independent prognostic factor a report from the SIOP 93-01 nephroblastoma trial and study. Eur J Cancer 43(1) 131-136... 

---