ABSTRACT
AIM: To evaluate the efficiency of the original ALL-MB-2002 protocol within the multicenter study of treatment of acute lymphoblastic leukemia (ALL) in children. SUBJECTS AND METHODS: A total of 1873 primary patients with ALL aged 1 to 18 years, of whom 1544 patients were enrolled in this study, were notified at 36 clinics of Russia and Belarus from April 15, 2002, to January 1, 2008. RESULTS: With the median observation of 4.12 years, 7-year event-free survival (EFS) was 73 +/- 13%; overall survival (OS) 78 +/- 2%; relapse-free survival 82 +/- 1%. The rates of EFS and OS were equal and amounted to 76 +/- 2 and 80 +/- 2% in the standard-risk group (SRG) and intermediate-risk group (ImRG), respectively. In the high-risk group (HRG) patients, EFS and OS were as high as 30 +/- 6 and 37 +/- 6%, respectively. The frequency of relapses with central nervous system lesion was as much as 4.7% in all the patients, 6-year cumulative risk for isolated neurorecurrences being 2.5% in the SRG patients. Adolescents, patients with the baseline leukocytosis (more than 100 x 10(9)/l), and those with a splenic size of over 4 cm or more from the costal arch margin had substantially worse survival rates. A poor early response to therapy (on induction days 8 and 15) was also associated with its lower efficiency. CONCLUSION: Despite a considerable rise in the number of centers and a slight increase in the intensity of therapy, the results of the new ALL-MB-2002 protocol are as minimum equivalents obtained in the use of the previous ALL-MB-91 protocol. A significant improvement in the overall results of therapy and a reduction in the cumulative risk for isolated neurorecurrences were noted in the ImRG patients.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Age Factors , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Child , Child, Preschool , Disease-Free Survival , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/prevention & control , Recurrence , RussiaABSTRACT
Authors present 7-year follow up of 567 patients with initial forms of chronic venous insufficiency (CVI) of lower extremities (442 patients with C-1 class and 125 patients with C-2 class). The analysis of individual clinical and ultrasonic data has shown wide variability and the lack of specificity in CVI symptomatology. Ultrasonic investigation revealed veno-venous reflux in 74.6% of patients with C-1 class. Complex outpatient care adhered the principles of minimal invasiveness and radicality, along with individual approach to surgical correction and drug therapy. Early (within 3 weeks) and late (3 and 12 months) outcomes were assessed, including trends in CVI subjective symptoms and objective evaluation of changes in superficial venous system. One year later full clinical and esthetic effect was achieved in 91.4% of C-1 class patients and in 75.8% of C-2 class patients.
