ABSTRACT
A total of 527 children with acute lymphoblastic leukaemia (ALL) from the most frequent risk groups: standard risk group (SRG) and intermediate risk group (IRG) were treated between 1987 and 1991 according to an intensified treatment program (based on the BFM protocol) including the use of an intermediate dose of methotrexate in the IRG. A comparison of the treatment results in this group from 513 children treated between 1981 and 1987 indicates that the chance for a 6 year event-free survival has increased to 73% (previously 55%).
Subject(s)
Antineoplastic Agents/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Antineoplastic Agents/administration & dosage , Child , Disease-Free Survival , Humans , Poland/epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Recurrence , Risk Factors , Time FactorsABSTRACT
In the past 16 years, 2004 children with acute lymphoblastic leukemia (ALL) have been treated in the Polish Pediatric Group centers. Eight hundred and eighty-seven (44.3%) of these patients discontinued treatment after the first remission. Acute lymphoblastic leukemia relapse occurred in 180 patients (20.3%). This group was analyzed for the method of treatment and its influence on long-term survival, the time between cessation of treatment and relapse, the character and localization of relapse and later follow-up. It was shown that the patients with the best chance of a second remission are those with late testicular relapse. The most frequent and prognostically poor are bone marrow (BM) relapses which warrant intensive chemotherapy with BM transplantation. Patients with ALL relapse still have the possibility of a second remission and long-term survival.
Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Asparaginase/administration & dosage , Child , Child, Preschool , Daunorubicin/administration & dosage , Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Prednisone/administration & dosage , Prognosis , Recurrence , Survival Rate , Vincristine/administration & dosageABSTRACT
Compression fractures of vertebrae were noted in 20 out of 1,700 children with the acute lymphoblastic leukemia. Usually prognosis in these cases has been favourable (70% of patients are alive from 5 months to 19 years). Percentage of recovery from compression fractures has been relatively high. Lymphoblastic leukemia with infiltrations localized in the spine is relatively non-aggressive, develops slowly, and despite extensive lesions to the bones its outcome results are favourable. Main symptom of spinal involvement include severe and persisting back aches which make walking impossible. Such symptoms should indicate the diagnosis of leukemia and advocate proper hematological examinations.
Subject(s)
Fractures, Spontaneous/etiology , Fractures, Stress/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Spinal Fractures/etiology , Spinal Neoplasms/complications , Child , Child, Preschool , Exercise Therapy , Female , Fractures, Spontaneous/rehabilitation , Fractures, Stress/rehabilitation , Humans , Male , Orthotic Devices , Prognosis , Wound HealingABSTRACT
Treatment results of 1304 children with ALL obtained in Poland are presented. A group of 524 patients has been subject to a detailed analysis. These patients have been treated in the years 1981-1985 according to the BFM Protocol. In this group the 6-years CCR probability amounts to 0.56.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Child , Child, Preschool , Clinical Trials as Topic , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Male , Poland , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Remission InductionSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Health Status , Health , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prenatal Exposure Delayed Effects , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Pregnancy , Time FactorsABSTRACT
Pharmacokinetics of the intrathecally given methotrexate (MTX) for protection of the central nervous system was studied in 17 children with acute lymphoblastic leukemia (ALL). MTX plasma levels were assayed by enzymatic inhibition. The first order rate constants for the absorption, distribution and elimination phases were calculated on the base of an open one or two compartment body model. The efflux of MTX from the cerebrospinal fluid compartment is sufficiently significant to worsen myelosuppression, especially in 3-7 year old children. Therefore MTX cannot be administered intrathecally to such young children unless the complete remission in the number of circulating granulocytes is achieved according to general rules.
Subject(s)
Methotrexate/pharmacokinetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Adolescent , Child , Child, Preschool , Humans , Injections, Spinal , Methotrexate/administration & dosage , Methotrexate/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapySubject(s)
Leukemia, Lymphoid/therapy , Adolescent , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child , Child, Preschool , Clinical Trials as Topic , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Infant , Leukemia, Lymphoid/drug therapy , Leukemia, Lymphoid/radiotherapy , Male , Time FactorsABSTRACT
The subject of analysis is a group of 111 children with acute lymphoid leukemia (ALL) whose remission has lasted at least 4 years since stopping treatment. Patients were observed from 4 to 18 years after ALL therapy. No symptoms of disease were observed in 110 children; one child had leukemic infiltration of the testes during the fifth year after stopping treatment. In this group of children no changes in physical development have been recorded, but a growth deficiency is sometimes noted. No symptoms of intrinsic organ lesions have been ascertained in most of the patients. All of the patients, except one with schizophrenia, lead normal lives and either attend school or go to work. Seven patients have healthy children, who were born 6-24 years after the beginning of the disease and 3-16 years after cessation of therapy.
Subject(s)
Child , Leukemia, Lymphoid/therapy , Adolescent , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Leukemia, Lymphoid/drug therapy , Leukemia, Lymphoid/radiotherapy , Male , Physical Examination , PregnancyABSTRACT
6-Mercaptopurine (6-MP)-induced sodium azide--iodine reaction was adapted for determination of 6-MP in urine of four children treated with single oral doses of the drug in tablets. Open one-compartment body model was assumed, and first-order elimination rate constants (K) and biological half-life times (t0,5) were calculated, and their precision was determined by statistical treatment.
Subject(s)
Leukemia, Lymphoid/urine , Mercaptopurine/urine , Child , Child, Preschool , Humans , Kinetics , Time FactorsSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Lymphoid/drug therapy , Adolescent , Asparaginase/administration & dosage , Child , Child, Preschool , Cytarabine/administration & dosage , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Infant , Male , Poland , Tennessee , Thioguanine/administration & dosageSubject(s)
Acid Phosphatase/analysis , Clinical Enzyme Tests , Leukemia/diagnosis , Peroxidases/analysis , Child , Child, Preschool , Histocytochemistry , Humans , Infant , Microscopy , Microscopy, Electron , PrognosisABSTRACT
The results of intensive treatment of 426 children with acute lymphoblastic leukaemia were analysed and compared with the results in 113 patients treated by sparing method. A considerable prolongation of the duration of the first remission and survival was observed in the group treated intensively. Thus 44.8% of children in that group had a chance of 5 years of survival, as compared with 1.2% of children treated by the sparing methods. A difference was demonstrated in the distribution of the duration of the first remission and the survival time depending on the initial white blood cell count with worse results in patients with very high leucocytosis. Brain involvement developed in 13.6% of cases. The proportion of children dying of infections despite continuing remission was 4.6%. In 72 children treatment of leukaemia was terminated.
