Semisynthetic derivative of podophyllotoxin which interacts with type II topoisomerase to induce DNA cross-links and double-strand breaks.
2 to 11%.
41% of children with acute lymphoblastic leukemia treated with intensive multiagent chemotherapy.
Children with neuroblastoma or brain tumors.
High doses (children): 1500 to 2000 mg/ m2.
(often on the first dose)
General: hypotension, oliguria, intravascular hemolysis, sweating, palor, fever.
Respiratory: chest pain, wheezing.
Cutaneous: flushing, urticaria, angioedema.
In vitro histamine release from basophil leukocytes: non-specific histamine release.
One case with IgG 1 antibody to teniposide.
Cremophor EL is thought to be the culprit (see cremophor EL).
Premedication with diphenydramine corticosteroids is useful.
Etoposide does not usually cross-react.