Intensification of Chemotherapy Using Block Therapies as Consolidation and Reinduction Therapies for Acute Lymphoblastic Leukemia During Childhood
| Autor: | Noriyuki Aoyagi, Kimihiko Sano, Masuji Yamamoto, Urara Koudera, Keisei Kawa-Ha, Hiroshi Miyata, Keiko Yumura-Yagi, Akio Tawa, Mutsuro Shimodera, Haruki Tanaka, Masahiro Sako, Junichi Hara, Hideo Misu, Park Yd, Osamu Mabuchi, Akira Yoshioka, Yoshiyuki Kosaka, Gaku Hosoi, Makiko Kikkawa |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Leukemia T-Cell Adolescent Childhood leukemia medicine.medical_treatment Gastroenterology Disease-Free Survival Immunophenotyping Risk Factors Internal medicine Acute lymphocytic leukemia Antineoplastic Combined Chemotherapy Protocols Leukemia B-Cell medicine Humans Child Survival rate Chemotherapy Hematology business.industry Infant Combination chemotherapy Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Surgery Survival Rate Leukemia Treatment Outcome Child Preschool Female business Follow-Up Studies |
| Zdroj: | International Journal of Hematology. 74:165-172 |
| ISSN: | 1865-3774 0925-5710 |
| Popis: | Between April 1994 and March 1997, 143 children (age range, 1-15 years) with newly diagnosed acute lymphoblastic leukemia (ALL), except for those patients with t(9;22), were treated according to protocol-94 of the Osaka Childhood Leukemia Study Group. In this trial, the intensity of chemotherapy was enforced in the consolidation and reinduction phases by introducing AML-type block therapies consisting of concentrated administration of 4 to 6 drugs during 5 or 6 days. For patients in the higher risk groups, rotational combination chemotherapy was introduced following the early phase. A total of 124 children with B-cell precursor ALL (B-pre ALL) were classified into 3 groups, the ultrahigh-risk group (UHRG) (15 patients), the high-risk group (HRG) (61 patients), or the standard-risk group (SRG) (48 patients), based on age. leukocyte count, immunophenotype, central nervous system leukemia, response to treatment, and selected chromosomal abnormalities. The complete remission rate was 93%, and the 6-year event-free survival (EFS) rate was 79%+/-4%. EFS rates for the UHRG, HRG, and SRG groups were 67%+/-12%, 80%+/-6%, and 81%+/-6%, respectively. Nineteen patients with T-cell ALL were treated with the protocol for the UHRG. Thirteen patients (68%) attained complete remission, and the 6-year EFS rate was 55%+/-12%. Thus, intensification of chemotherapy improved the EFS rate and AML-type block therapies appeared to be effective as the consolidation and reinduction therapies for B-pre ALL. |
| Databáze: | OpenAIRE |
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