Treatment for Children with Standard-Risk Acute Lymphoblastic Leukemia.
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概要
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In a study by the Children's Cancer and Leukemia Study Group (CCLSG), it was observed that event free survival (EFS) improved steadily through the CCLSG-811 to 911 protocols for children with standard-risk (SR) acute lymphoblastic leukemia (ALL). The stratification of prognostic groups according to age and leuko-cyte count at diagnosis is the same in all CCLSG studies of ALL. The EFS rate at 14 years was 65.4% for the intermittent cyclic regimen of an intermediate-dose of methotrexate (MTX) plus 6-mercaptopurine (6MP). This regimen has become a standard for maintenance chemotherapy since the 841 protocol of CCLSG. In the 841 protocol, L-asparaginase (L-asp) containing induction therapy improved the EFS rate. In the 874 protocol, there was no significant difference between the two regimens, with and without cranial irradiation, in preventing central nervous system leukemia. The objectives of CCLSG studies are to obtain meaningful and reasonable results, introduce new concepts and prove them to all investigators based on previous studies. The usefulness of the dose escalation of 6MP, 24-hour infusion of MTX without CF rescue and the phamacokinetic variation of 6MP, as well as the usefulness of an intermittent and cyclic regimen of L-asp, will be clarified in ongoing prospective studies.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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