ABSTRACT
AIM: A comparative analysis of efficacy and toxicity of two chemotherapy regimens: standard German protocol ALL-BFM 90m and less intensive original test protocol ALL-MB 91 in a multicenter trial of acute lymphoblastic leukemia (ALL) in children. MATERIAL AND METHODS: In 1995-2002 a total of 834 patients with newly diagnosed ALL aged 0-18 years were admitted to 10 clinics of Russia. Of them, 713 were randomized in two groups: treatment program ALL-BFM 90m (n = 355) and ALL-MB 91 program (n = 358). RESULTS: In 7-year follow-up median, 10-year event-free survival (EFS) and overall survival (OS) did not differ significantly between the groups and was 67 +/- 3 and 68 +/- 3% (ALL-MB 91) and 74 +/- 2, 71 +/- 3% (ALL-BFM 90m), respectively. Though the rate of isolated recurrences in CNS in patients on the protocol ALL-MB 91 was 2.8%, they developed only in 0.8% patients of the standard risk group. Anemia, thrombocytopenia and agranulocytosis developed less frequently, hospital stay was significantly shorter on the test protocol vs the control one (p < 0.01). CONCLUSION: EFS and OS on the test (ALL-MB 91) and control (ALL-BFM 90m) protocols were equivalent in lower toxicity and cost of therapy.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/economics , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Asparaginase/adverse effects , Asparaginase/economics , Asparaginase/therapeutic use , Child , Child, Preschool , Cyclophosphamide/adverse effects , Cyclophosphamide/economics , Cyclophosphamide/therapeutic use , Cytarabine/adverse effects , Cytarabine/economics , Cytarabine/therapeutic use , Daunorubicin/adverse effects , Daunorubicin/economics , Daunorubicin/therapeutic use , Female , Humans , Male , Mercaptopurine/adverse effects , Mercaptopurine/economics , Mercaptopurine/therapeutic use , Methotrexate/adverse effects , Methotrexate/economics , Methotrexate/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Prednisone/adverse effects , Prednisone/economics , Prednisone/therapeutic use , Treatment Outcome , Vincristine/adverse effects , Vincristine/economics , Vincristine/therapeutic useABSTRACT
Clinical efficacy of 3rd generation cephalosporins i.e. oral cefpodoxime and parenteral ceftriaxone was studied in the treatment of children with oncohematologic pathology. Cefpodoxime proved to be efficient in cases of moderate infectious complications in regard to the respiratory tracts. The oral administration of the drug provided its usage in outpatients. Ceftriaxone had a favourable effect in the treatment of children with more severe processes as a rule at the background of agranulocytosis and a lower immune response often with a tendency to generalization. No side effects of the cephalosporins were observed.
