RESUMEN
UNLABELLED: We discuss the history and progress of treatment for acute myelogenous leukemia (AML) in children as it has evolved over the past decade. We review the results of clinical trails for children with AML and examine the major strategies that have contributed to progresses in the treatment of this disease. Prior to the 1970's, nearly every child with AML died. Modern intensive chemotherapy, bone marrow transplantation, and advanced supportive care of critically ill patients have improved the outlook for children with this fatal disease. CONCLUSION: Although it represents only 15-20% of all childhood acute leukemias, > 30% of deaths from leukemia are still a consequence of AML, and only 30-40% of children with newly diagnosed AML are expected to achieve a long-term remission. Greater advances in treatment are expected as headway is made in understanding the complex biology of this heterogeneous disease.
Asunto(s)
Ensayos Clínicos como Asunto , Leucemia Mieloide Aguda/terapia , Trasplante de Médula Ósea , Niño , Preescolar , Femenino , Humanos , Masculino , Inducción de RemisiónRESUMEN
The outcomes for five patients with retinoblastoma and constitutional chromosomal abnormalities involving the long arm of chromosome 13 are reported. All patients demonstrated developmental delay and mental retardation. Four of these patients are alive 23, 21, 15, and 1 year from diagnosis; one died of pneumonia with septicemia. Each of the four survivors has, with aging, shown hypotonia, mutism, contractures, and inability to function independently.
Asunto(s)
Anomalías Múltiples/genética , Aberraciones Cromosómicas/genética , Cromosomas Humanos Par 13/ultraestructura , Neoplasias del Ojo/epidemiología , Genes de Retinoblastoma , Discapacidad Intelectual/genética , Retinoblastoma/epidemiología , Trastornos de los Cromosomas , Neoplasias del Ojo/genética , Neoplasias del Ojo/terapia , Femenino , Trastornos del Crecimiento/genética , Humanos , Lactante , Recién Nacido , Masculino , Neoplasias Primarias Múltiples/genética , Pronóstico , Retinoblastoma/genética , Retinoblastoma/terapia , Sobrevivientes , Tennessee/epidemiologíaRESUMEN
Because few patients with extraocular retinoblastoma are seen in the United States and Europe, it has been difficult to establish the optimal role of chemotherapy in such cases. We examined the efficacy of two chemotherapy combinations (cisplatin/etoposide and cyclophosphamide/doxorubicin) in patients with extraretinal retinoblastoma, administered prior to radiotherapy in four patients with recurrent or advanced primary disease. Responses were evaluable in three patients, each of whom was treated by both chemotherapy regimens and radiotherapy. Multimodality therapy promises to be of benefit to patients with extraocular retinoblastoma, and future studies will explore alternative chemotherapy combinations for this purpose.
