Download Central Nervous System Leukemia: Prevention and Treatment by R. A. Price (auth.), Renato Mastrangelo MD, David G. Poplack PDF

By R. A. Price (auth.), Renato Mastrangelo MD, David G. Poplack MD, Riccardo Riccardi MD (eds.)

In the prior 10 to IS years there was dramatic development within the survival of kids with acute lymphoblastic leukemia. this present day, over 50% of kids with this illness might be alive and freed from their sickness at the least five years from the time in their preliminary prognosis. even if a few elements have contributed to this development, possibly none has been as very important because the establishment of principal fearful process preventive remedy (eNS prophylaxis). even though, regardless of the efficacy of eNS prophylaxis, the prevention and remedy of vital frightened procedure leukemia keeps to pose a powerful scientific problem to the pediatric oncologist. even if profitable ordinarily, eNS preventive remedy is still useless for a small yet major subset of sufferers at excessive chance for constructing eNS disorder. furthermore, it has turn into more and more glaring that a few equipment of eNS preventive remedy are linked to long term, opposed eNS sequelae. hence, substantial controversy exists in regards to the optimum approach to eNS prophylaxis. therapy of the sufferer who develops overt meningeal leukemia has no longer been as winning and keeps to pose a massive medical problem. regardless of the power of intrathecal chemotherapy and/or radiation remedy to urge eNS remission, so much sufferers endure next relapse and supreme survival is mostly signifi­ cantly compromised. it really is obvious that more recent techniques to remedy for this sufferer staff has to be pointed out prior to significant development for this sufferer team is probably going to occur.

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Radiology 104:649-652, 1972. 12. Coccia P, Sather H, Nesbit M, Weiner J, Donaldson M, Hittle R, Ortega J, Hammond D: Interrelationship of initial WBC, age and sex in predicting prognosis in childhood acute lymphoblastic leukemia (Abstr. #214). Proc Am Hematol, 1976, p 125. 13. Nesbit ME, Sather HN, Robison LL, Ortega J, Littman PS, D'Angio GJ, Hammond GD: Presymptomatic central nervous system therapy in previously untreated childhood acute lymphoblastic leukemia: comparison of 1800 rad and 2400 rad.

These trends were apparent for both high- and low-count patients, but achieved statistical significance only for the latter group (Table 2). In UKALL I, no significant difference has yet emerged between the three fractionation schedules for cranial irradiation, though the CNS relapse rate appears to be somewhat lower in the group receiving the largest number of fractions than in the remainder (Figure 3). BOlle-marrolt' relapse. For the purposes of the present analysis, the duration of Table 1. UKALL I-V: Case material NR, patients not in complete remission at 12 weeks and excluded from the present analyses.

A report for Children's Cancer Study Group. Lancet 1:461-466, 1981. 14. Zuelzer WW: Implications of long term survival in acute stem cell leukemia of childhood treated with comparable cyclic therapy. Blood 26:477-494, 1964. IS. Ravindranath Y, Inoue S, Considine B, Lusher JM, Zuelzer WW: New leukemia in the course of therapy of acute lymphoblastic leukemia. Am J Hematol 5:211-223, 1978. 16. Mosijczuk AD, Ruymann FR: Second malignancy in acute lymphocytic leukemia. Review of 33 cases. Am J Dis Child 135:313-316, 1981.

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