小児急性リンパ性白血病における化学療法:大阪小児白血病治療研究グループの最新の治療成績を中心に

概要

論文の詳細を見る
Seventy children with acute lymphoblastic leukemia (ALL) who were enrolled in the Osaka Children's Leukemia Study Group over a 36 month period were treated with several regimens on the basis of the presence or absence of certain risk factors at the time of diagnosis. Patients were defined as being at high risk when they had one or more of the following risk factors: age below two or above ten years, a white cell count of 20,000/u1 or more, the presence of T-cell immunological markers, radiologic evidence of a mediastinal mass, involvement of the central nervous system, and leukemia/lymphoma syndrome. Patients in both the standard-risk and high-risk groups were treated for two or three years, receiving an intensive remission induction therapy, central nervous system prophylaxis, consolidation therapy and maintenance therapy. We classified the patients according to above risk factors and assigned them to either one of the six regimens prospectively. The event-free survival rates at two years of the patients in the standard-risk, high -risk and ultra high-risk groups were 64%,76% and 76.2%, respectively. While these results indicate an improvement compared with that with the previous methods, careful selection of risk categories will be the major purpose of future studies so as to institute a more appropriate treatment for high risk patients while minimising the therapy for low risk patients.
Kinki Brain Tumor Pathology Conferenceの論文