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1.
Clin Radiol ; 55(3): 193-7, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10708612

ABSTRACT

OBJECTIVE: The diagnosis of early local recurrence of soft tissue sarcomas, especially in those treated with surgery and radiotherapy, is a difficult clinical problem. Financial constraints led us to use ultrasonography instead of CT or MR imaging. The aim of this study was to evaluate the role of ultrasonography (US) in detecting local recurrence. METHODS AND RESULTS: Fifty patients with previous treatment for soft tissue sarcomas were evaluated prospectively for recurrence by US and histopathology. Seven of the 50 patients were clinically suspected to have recurrent tumour. Ultrasonography showed recurrence in 26, no recurrence in 18, benign disease in four and was indeterminate in two cases. Ultrasonography was instrumental in guiding fine needle aspiration biopsies of small local recurrences and indeterminate lesions in 17 patients. In the sonographically tumour positive patients, histopathology confirmed recurrence in 24; one case had benign disease and one patient refused surgery. Thirteen of the 18 sonographically tumour negative patients were operated upon; all were negative for tumour on histopathology. Both the indeterminate cases showed recurrence on histopathology. The benign cases were confirmed by histopathology correlation. Ultrasound guided fine needle aspiration cytology (FNAC) was positive in 14 out of 17 patients (88%). The sensitivity and specificity of US was 92.30% and 94.4% respectively. CONCLUSION: Our study concludes that US is an extremely useful and cost effective method in the detection of early local recurrences of soft tissue sarcomas and should therefore be used for initial routine follow-up and guided biopsies.


Subject(s)
Neoplasm Recurrence, Local/diagnostic imaging , Sarcoma/diagnostic imaging , Soft Tissue Neoplasms/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , Ultrasonography
2.
Leuk Res ; 23(2): 195-7, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10071136

ABSTRACT

A case of sezary syndrome where the sezary cells showed cytoplasmic hairy projections is reported. The patient had typical exfoliative erythematous dermatitis, high white cell count, atypical lymphocytes of T-phenotype with folded nuclei and bone marrow involvement. The ultra structure study showed cerebriform nucleus and cytoplasmic projections.


Subject(s)
Lymphocytes/ultrastructure , Sezary Syndrome/ultrastructure , Skin Neoplasms/ultrastructure , Adult , Humans , Male , Sezary Syndrome/pathology , Skin Neoplasms/pathology
3.
Leuk Lymphoma ; 20(3-4): 311-5, 1996 Jan.
Article in English | MEDLINE | ID: mdl-8624472

ABSTRACT

The purpose of this study was to analyze the outcome of patients who completed therapy for acute lymphoblastic leukemia (ALL) and to study the role of an aggressive induction regimen in preventing post therapy relapses. Four hundred and twenty-two patients with ALL who completed therapy during the period 1975-1991 were followed. Two hundred and sixty patients received the aggressive MCP 841 protocol and 162 patients received various other less aggressive treatment regimens. Patients were followed with periodic examination and complete blood counts. The incidence of post therapy relapse was 27% in the less aggressive protocols and 15% in the MCP 841 protocol (p = 0.001). An higher percentage of relapses was seen in males (p = 0.05) and 89% relapses occurred within two years of stopping therapy. The relapse rate after 5 years of cessation of therapy was 0.59%. In conclusion, aggressive induction therapy is the most crucial factor in predicting relapses following cessation of therapy in ALL patients. However, relapses are unlikely to occur five years post therapy.


Subject(s)
Antineoplastic Agents/administration & dosage , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Age Factors , Child , Child, Preschool , Disease-Free Survival , Female , Humans , India , Leukocyte Count , Male , Recurrence , Registries , Retrospective Studies , Sex Factors
4.
Indian J Cancer ; 32(2): 77-80, 1995 Jun.
Article in English | MEDLINE | ID: mdl-9136462

ABSTRACT

In an ongoing trial at our institute 10 patients of high grade osteogenic sarcoma of the extremities have been treated with preoperative chemotherapy including ifosfamide 2 mg/M2/day i.v. for 5 days, doxorubicin 20 mg/M2/day i.v. for 3 days and cisplatinum 120 mg/M2 i.v. on day 1 at 3-4 weeks interval for 2 courses followed by surgery. One patient refused surgery and further treatment. Pathological study of the 9 surgical specimens showed grade IV necrosis in 5, grade III necrosis in 2 and grade I & II necrosis in 2. Overall response rate (Grade III & IV) was 87.5%. The patients showing Grade III/IV response received a further 3 cycles of the same chemotherapy postoperatively. The patient who refused surgery is still alive at 30 months. Our followup ranges from 4-34 months. All patients developed myelosuppression and one patient died after 4th course of chemotherapy due to septicemia. We expect grade IV response to preoperative chemotherapy will be translated into longer disease free survival. Protocols followed in western countries are not practicable in Asian countries. Hence this new combination has been developed without compromising response rate.


Subject(s)
Bone Neoplasms/therapy , Extremities , Osteosarcoma/therapy , Bone Neoplasms/economics , Cost-Benefit Analysis , Humans , Osteosarcoma/economics
5.
Indian J Cancer ; 30(4): 169-75, 1993 Dec.
Article in English | MEDLINE | ID: mdl-8206499

ABSTRACT

Eighty eight patients with myelodysplastic syndromes were studied to determine the clinical and pathological features and the prognosis. All the patients had anemia. Neutropenia was seen in 44% and thrombocytopenia in 78% patients. The subtypes included refractory anemia in six, refractory anemia with ringed sideroblasts in three, refractory anemia with excess blasts in 30, refractory anemia with excess blasts in transformation in 32 and chronic myelomonocytic anemia in 17 patients. Forty four patients who received chemotherapy were evaluable for response. Three of the 15 patients treated with hydroxyurea achieved partial remission. Eighteen patients were treated with low dose cytosine arabinoside and complete remission was achieved in five and partial response in six patients. Aggressive chemotherapy was given to 11 patients at the onset of the illness resulting in complete remission in six and partial response in two patients. Nineteen of the 88 patients transformed to acute myeloid leukemia. The crude survival of all the patients ranged from 15 days to 22.5 months. The mortality was due to hemorrhage in 15% and septicemia in 85%. Our data reveals ineffectiveness of the current therapy and emphasizes on the need to develop newer therapeutic approaches.


Subject(s)
Myelodysplastic Syndromes/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Myelodysplastic Syndromes/mortality , Myelodysplastic Syndromes/therapy , Prognosis , Survival Rate , Treatment Outcome
6.
Am J Hematol ; 43(1): 10-3, 1993 May.
Article in English | MEDLINE | ID: mdl-8317457

ABSTRACT

Fifteen patients with lymphoid blast crisis of chronic myelogenous leukemia (LyBC-CML) and five patients with acute lymphoblastic leukemia converting to Philadelphia-positive (Ph+) chronic myeloid leukemia (ALL Ph + CML) were followed. Seven of 15 (46.7%) LyBC-CML patients developed meningeal leukemia within a median period of 6 months (range 2-11 months), while there was no medullary relapse. Five of these responded well to triple intrathecal therapy. In the ALL Ph + CML patients, in spite of central nervous system (CNS) prophylaxis with IT MTX and 18 Gy cranial radiation, two of five patients (40%) experienced meningeal leukemia, one isolated and the other with medullary relapse. The data confirm that LyBC-CML patients experience a high incidence of meningeal leukemia. The role of CNS prophylaxis is not very clear, but its use may delay development and reduce morbidity due to CNS disease.


Subject(s)
Blast Crisis/physiopathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/physiopathology , Leukemic Infiltration/epidemiology , Meninges/pathology , Blast Crisis/mortality , HLA-DR Antigens/analysis , Humans , Incidence , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality , Leukemic Infiltration/mortality , Leukemic Infiltration/prevention & control , Leukemic Infiltration/therapy , Methotrexate/therapeutic use , Neprilysin/analysis , Radiotherapy/methods , Survival Analysis , Time Factors
7.
J Surg Oncol ; 52(3): 181-4, 1993 Mar.
Article in English | MEDLINE | ID: mdl-8441277

ABSTRACT

Twenty-nine patients with high-grade nonmetastatic osteogenic sarcoma of the extremities were treated with adjuvant chemotherapy following definitive surgery. Chemotherapy consisted of systemic intravenous Adriamycin and cisplatin in a sequential fashion given for six courses. Nineteen out of 29 patients are alive and continuously disease free over a follow-up period ranging from 9+ to 30+ months. The relapse-free survival was 72%, and overall survival for the entire group was 69%. Median survival is not reached yet. Six out of 29 patients relapsed, of which 1 patient is alive for 6+ months after relapse. Three patients died of chemotherapy toxicity. The results were superior to historical controls treated with surgery alone. The need for more aggressive treatment approaches is discussed.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Arm , Bone Neoplasms/drug therapy , Leg , Osteosarcoma/drug therapy , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy, Adjuvant , Child , Cisplatin/administration & dosage , Doxorubicin/administration & dosage , Drug Administration Schedule , Female , Humans , Infusions, Intravenous , Male , Survival Analysis
8.
Indian J Med Res ; 98: 8-14, 1993 Feb.
Article in English | MEDLINE | ID: mdl-8388366

ABSTRACT

Fifty three newly diagnosed patients of de novo acute myelogenous leukaemia (AML) received treatment consisting of remission induction with daunorubicin 60 mg/m2 on day one and continuous infusion of cytosine arabinoside 200 mg/m2/day over 24 h from day one to 7. Thereafter patients in complete remission received consolidation chemotherapy with two identical courses. Complete remission (CR) could be achieved in 40 patients (75.5%). Seven patients (13.2%) died with complications during aplasia phase following remission induction therapy while six patients (11.3%) had resistant disease. Twenty seven patients (67.5%) developed relapse while eight patients (15.1%) continue to remain in complete remission ranging from 51 to 68 months (median 62.5). The projected event free survival and disease free survival at 60 months is 15 per cent (SE + 11.9%) and 21 per cent (+6%) respectively. Evaluation of the prognostic significance of pretherapy characteristics showed that infection at presentation and low number of myeloperoxidase (MPO) containing blasts affected the achievement of complete remission adversely on univariate analysis. Similarly age at diagnosis, of more than 45 yr, total leucocyte count of 50,000/cumm or more and low number of MPO containing blasts affected the remission duration (disease free survival) adversely on univariate analysis. On multivariate analysis, MPO positivity of blast cells, remained the only significant independent characteristic. High MPO positivity affected the remission duration favourably (P < 0.01). Patients with high MPO positivity also achieved CR with one induction cycle in 32 out of 40 instances while only 2 out of 5 patients with low MPO positivity, achieved CR with one chemotherapy cycle (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Hematopoietic Stem Cells/enzymology , Leukemia, Myeloid, Acute/drug therapy , Peroxidase/metabolism , Adolescent , Adult , Cytarabine/administration & dosage , Daunorubicin/administration & dosage , Female , Humans , Leukemia, Myeloid, Acute/pathology , Male , Middle Aged , Prognosis , Recurrence , Remission Induction
9.
Neoplasma ; 40(1): 15-20, 1993.
Article in English | MEDLINE | ID: mdl-8350943

ABSTRACT

Peripheral blood lymphocytes (PBL) and lymph node lymphocytes (LNL) from non-Hodgkin's lymphoma patients were tested for LAK cell cytotoxicity using appropriate targets in a short-term 51chromium-release assay. The results showed a significant depression in LNL-LAK activity suggesting the reduced capacity of LNL to generate LAK cells. LNL-LAK cells demonstrated significantly low percentages of cells expressing CD16, CD56 and CD25 as compared to PBL-LAK of patients and healthy donors. The reduced capacity to generate LAK cells in lymph nodes could be due to the presence of low numbers of NK cells which are thought to be the main precursors of LAK cells. The IL-2 producing ability of lymph node mononuclear cells was found to be significantly higher than that of peripheral blood mononuclear cells from both healthy donors and NHL patients.


Subject(s)
Killer Cells, Lymphokine-Activated/immunology , Lymph Nodes/pathology , Lymphoma, Non-Hodgkin/pathology , Adult , Antigens, CD/analysis , Cytotoxicity Tests, Immunologic , Humans , Immunophenotyping , Interleukin-2/biosynthesis , Leukocytes, Mononuclear/immunology , Lymph Nodes/immunology , Lymphoma, Non-Hodgkin/blood , Lymphoma, Non-Hodgkin/immunology
10.
Leuk Lymphoma ; 8(6): 503-4, 1992 Dec.
Article in English | MEDLINE | ID: mdl-1297484

ABSTRACT

Urinary bladder cancers following prolonged cyclophosphamide therapy are being increasingly reported. We report a case of transitional cell carcinoma of the urinary bladder occurring 12 years after pulse intravenous therapy with cyclophosphamide for Hodgkin's disease. The mechanism of bladder carcinogenesis and the possible role of the uroprotector MESNA in preventing cyclophosphamide induced bladder cancer are discussed.


Subject(s)
Cyclophosphamide/adverse effects , Hodgkin Disease/drug therapy , Neoplasms, Second Primary/chemically induced , Urinary Bladder Neoplasms/chemically induced , Humans , Male , Mesna/pharmacology , Middle Aged
11.
Indian J Cancer ; 29(3): 159-63, 1992 Sep.
Article in English | MEDLINE | ID: mdl-1292999

ABSTRACT

Pure red cell aplasia associated with lymphoproliferative malignancies other than thymoma is an uncommon occurrence. In the present paper we report a rare case of nodular non-Hodgkin's lymphoma with pure red cell aplasia who presented with symptoms related to anemia rather than the lymphoma and responded well to combination chemotherapy.


Subject(s)
Lymphoma, Non-Hodgkin/complications , Red-Cell Aplasia, Pure/complications , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Humans , Lymphoma, Non-Hodgkin/drug therapy , Red-Cell Aplasia, Pure/drug therapy
12.
Am J Hematol ; 40(3): 226-8, 1992 Jul.
Article in English | MEDLINE | ID: mdl-1609777

ABSTRACT

We report two patients with primary plasma cell leukemia (PLC) treated with a single agent, ifosfamide. One patient had a total disappearance of plasma cells (PC) from the peripheral blood and the bone marrow and disappearance of the myeloma protein, is disease free 8 months after completion of treatment, and alive 14 months after diagnosis. The second patient had a partial response with persistence of plasma cells in the bone marrow lasting 7 months, after which she had a frank relapse of the disease. We suggest that ifosfamide may be an active agent in plasma cell malignancies and needs further evaluation in multiple myeloma.


Subject(s)
Ifosfamide/therapeutic use , Leukemia, Plasma Cell/drug therapy , Adult , Female , Humans , Middle Aged
13.
J Assoc Physicians India ; 40(6): 410-2, 1992 Jun.
Article in English | MEDLINE | ID: mdl-1452569

ABSTRACT

Mixed opportunistic infection with Pneumocystis carinii and Candida prior to cytotoxic therapy in a young male diagnosed as having acute non-lymphoblastic leukaemia resulted in early catastrophe. The role of awareness of this complication and its prompt management is discussed.


Subject(s)
Leukemia, Myeloid, Acute/diagnosis , Opportunistic Infections/diagnosis , Pneumonia, Pneumocystis/diagnosis , Adult , Bone Marrow/pathology , Humans , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/pathology , Lung/pathology , Male , Opportunistic Infections/drug therapy , Opportunistic Infections/pathology , Pneumonia, Pneumocystis/drug therapy , Pneumonia, Pneumocystis/pathology , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use
14.
Am J Hematol ; 39(4): 242-8, 1992 Apr.
Article in English | MEDLINE | ID: mdl-1553952

ABSTRACT

During 1984-1986, a total of 128 children with acute lymphoblastic leukemia (ALL) were treated with an induction-consolidation regimen consisting of doxorubicin, vincristine, cytosine-arabinoside, and prednisolone. One hundred two (80%) patients belonged to high-risk group. The complete remission rate for all the patients was 91%. The event-free survival at 5 years was 32.0% +/- 23%. On multivariate analysis the event-free survival and disease-free survival was not altered by age, sex, WBC count, platelet count, LDH level, and surface phenotype. Infection due to prolonged marrow aplasia was a common complication, leading to mortality of 8 patients during induction and 33 patients during first remission. The relapse rate has been 36% (42 patients). The predominance of high-risk ALL in the Indian population underscores the need for intensive therapy. Improved supportive care during induction and remission seems essential to decrease therapy-related mortality, leading to improved survival.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Child , Child, Preschool , Cytarabine/administration & dosage , Cytarabine/adverse effects , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Female , Humans , India/epidemiology , Male , Multivariate Analysis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Prednisolone/administration & dosage , Prednisolone/adverse effects , Prognosis , Remission Induction , Vincristine/administration & dosage , Vincristine/adverse effects
15.
J Assoc Physicians India ; 40(3): 159-61, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1634479

ABSTRACT

In the last decade, 14 patients were diagnosed as having hairy cell leukemia (HCL) at our hospital; five of these were treated with the biological response modifier, recombinant alpha-interferon (IFN), as their initial treatment. Four of these cases showed a complete remission of the disease while one had a good partial response after a few months of therapy. One case is in unmaintained remission while one has relapsed with a just palpable spleen on stopping the drug; two are still on intermittent IFN therapy while one has been lost to follow up. Fever and skin rash were the most common side effects observed but did not warrant reduction of dose or stoppage of treatment. We conclude that IFN is highly effective and well tolerated as initial treatment of HCL in a country like India. Splenectomy will continue to be the first line therapy in the majority of cases but, in certain selected situations, IFN can be an extremely useful alternative.


Subject(s)
Interferon-alpha/therapeutic use , Leukemia, Hairy Cell/therapy , Humans , India/epidemiology , Interferon alpha-2 , Leukemia, Hairy Cell/epidemiology , Male , Middle Aged , Recombinant Proteins , Splenectomy
16.
Med Hypotheses ; 35(4): 307-10, 1991 Aug.
Article in English | MEDLINE | ID: mdl-1943880

ABSTRACT

CML, a myeloproliferative clonal disorder of myeloid stem cells, is characterized by the consistent presence of a bcr-c-abl fusion gene which is formed as a result of a translocation of the c-abl gene from chromosome 9 to downstream of the bcr gene on chromosome 22 (ph'). Current approaches to the treatment of CML are chemotherapy (conventional or aggressive with immuno-modulators) and bone marrow transplantation (BMT). Neither of the above treatment modalities results in long-term remission or cure. Hence, an alternative approach which aims at correcting the genetic defect should be considered. Taking advantage of the consistent abnormal presence of the bcr-c-abl gene in the treated and untreated CML patients at all stages, a gene therapy at the level of blocking mRNA might be considered. Such an antisense RNA therapy should include removal of patient's bone marrow, administration of the gene for constitutive expression of an antisense RNA for the bcr-c-abl fusion gene into the myeloid stem cells and reinjecting the engineered marrow into the patient. Such an approach, comparable to autologous BMT, will have the advantages of absence of graft rejection and possibility of 100% remission. The possible nature of the gene construct for such an antisense RNA therapy is discussed.


Subject(s)
Genetic Therapy , Leukemia, Lymphocytic, Chronic, B-Cell/therapy , RNA, Antisense/therapeutic use , Transfection , Bone Marrow Transplantation , Fusion Proteins, bcr-abl/genetics , Genes, abl , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/genetics , RNA, Messenger/drug effects , RNA, Messenger/genetics
17.
J Assoc Physicians India ; 38(12): 897-9, 1990 Dec.
Article in English | MEDLINE | ID: mdl-2096122

ABSTRACT

Aggressive chemotherapy regimens and supportive measures in haemato-oncology patients demand reliable venous access. Experience with this method in India has been limited. During a period of six months, we have used 42 subclavian indwelling catheters and 31 cubital Cavafix long lines. The mean age of patients in the two groups was 32 years and 7 years respectively. Subclavian catheters had a median duration of catheter placement of 46 days (range 4-145) and total 1494 catheter days, while cubital longlines yielded a median duration of insertion of 14 days (range 4-27) and total 508 catheter days. Catheter related complications were infection in 25% of patients, thrombophlebitis in 22%, blockade in 12% and misplacement in 17% in both groups taken together. The patients and families were extremely satisfied with the devices. Our experience supports further use of durable venous access in cancer patients. Implanted central venous catheters should be preferred whenever feasible.


Subject(s)
Antineoplastic Agents/administration & dosage , Catheterization, Central Venous/methods , Subclavian Vein , Adolescent , Adult , Age Factors , Child , Child, Preschool , Drug Administration Routes , Humans , India , Infant , Middle Aged
18.
Indian J Med Res ; 92: 83-5, 1990 Apr.
Article in English | MEDLINE | ID: mdl-1695200

ABSTRACT

The effect of hydroxyurea on foetal haemoglobin (HbF) levels was evaluated in 36 patients of myeloproliferative and myelodysplastic disorders. In 17 (47.2%) patients, HbF levels increased from 1.40 +/- 1.17 to 3.03 +/- 1.97 per cent after 4 wk therapy with hydroxyurea. In the responders this increase was highly significant (P less than 0.001). The rise in the HbF levels after hydroxyurea therapy was significant in patients with chronic myeloid leukaemia but not in the other groups.


Subject(s)
Fetal Hemoglobin/analysis , Hydroxyurea/pharmacology , Myelodysplastic Syndromes/blood , Myeloproliferative Disorders/blood , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged
19.
Indian Pediatr ; 27(1): 14-20, 1990 Jan.
Article in English | MEDLINE | ID: mdl-2361737

ABSTRACT

Twenty-nine children (age range 1-14, median 8 years) with acute non-lymphoblastic leukemia (ANLL) were induced in remission with daunorubicin and cytosine arabinoside. Twenty-three (79.3%) patients achieved complete remission (CR) and were administered two cycles of the same drugs as consolidation therapy; no maintenance treatment was given. Three (10.3%) patients died during induction; 3 (10.3%) patients were resistant to therapy. Multivariate analysis showed that female sex, TLC less than 50 X 10(9)/L, absence of in ection, albumin greater than 3.5 g/dl and high myeloperoxidase activity had a favourable influence on achievement of CR. TLC less than 50 X 10(9)/L and albumin greater than 3.5 g/dl also had a favourable prognostic value. Eight patients are alive between 13 and 32 months with overall survival at 2 years being 27.5%; four patients are free of disease with projected DFS at 2 years being 13.7%. The present data indicates the need for newer approaches to improve the long term survival in childhood ANLL.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Adolescent , Child , Child, Preschool , Cytarabine/administration & dosage , Daunorubicin/administration & dosage , Female , Humans , Infant , Leukemia, Myeloid, Acute/mortality , Male , Prognosis , Remission Induction/methods
20.
Indian J Cancer ; 26(3): 180-8, 1989 Sep.
Article in English | MEDLINE | ID: mdl-2630428

ABSTRACT

Two hundred and nine children (20 years and below) diagnosed as acute lymphoblastic leukemia between January 1980 and December 1983 were retrospectively analysed to evaluate the clinical features, prognostic factors and the results of therapy. One hundred and eighty one evaluable patients were treated with three different chemotherapy regimens consisting of vincristine and prednisolone (Group-A), vincristine, prednisolone and L-asparaginase (Group B-60 patients), and vincristine, prednisolone and adriamycin (Group C-81 patients). Complete remission was achieved in 152 (84%) patients, remission induction being 75 percent, 85 percent and 88 percent in Group A, B and C respectively. At a median follow-up of 36 months the disease free survival for complete responders was 35.5 patient. The disease-free survival for Group A, B and C was 20 percent, 47 percent 34 percent respectively indicating the superiority of a three drug regimen over the conventional two drug regimen. Patients at standard risk in each group had significantly better survival when compared to those at high risk. A 3-drug treatment regimen was superior to the 2-drug regimen and a low initial leucocyte count was an important favourable prognostic factor.


Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Prognosis , Remission Induction , Retrospective Studies
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