Very early remission and increased apoptosis with the use of Pentoxifylline in children with acute lymphoblastic leukemia

Despite the improvement in survival in acute lymphoblastic leukemia (ALL), there are still cases with evasion of chemotherapy-induced apoptosis. The IKK/NF-κB signaling pathway contributes to antiapoptotic gene expression. Pentoxifylline (PTX) inhibits IkB phosphorylation, blocking NF-κB and antiapoptotic activity. We conducted a randomized, double-blind clinical trial on pediatric ALL patients undergoing induction therapy, assigning them to PTX or placebo group. Bone marrow aspirates were obtained on days 1, 8, 15, and 22. Apoptosis was assessed using Annexin-V/propidium iodide. Results indicated that the PTX group exhibited higher apoptosis on day-8 (41.3% vs. 19.4%, =0.029) and day-15 (35.0% vs. 14.2%,