Treatment Results of the Tokai-POSG 8610HR Pilot Protocol for Children with High-Risk Acute Lymphoblastic Leukemia.
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We reported the treatment results of Tokai-POSG 8610HR pilot protocol for children with high-risk acute lymphoblastic leukemia (ALL). From Oct. 1986 to Jan. 1991, 43 eligible children were enrolled, who had one or more following high-risk factors : age≥10 years old, initial white blood cell count (WBC) of 50, 000/μl or more, and extramedullary leukemia. All patients received induction therapy consisting of vincristine, dexamethasone, cyclophosphamide and daunorubicin, followed by central nervous system prophylaxis by 24 Gy cranial irradiation, consolidation therapy and cyclic maintenance by multidrugs for 3 years after diagnosis. Complete remission was achieved in 39 patients. The 5-year event-free survival (EFS) rate was 72.6 ± 7.1%. The only factor of an adverse association with EFS was a initial WBC of 10, 000/μl or more (<I>p</I> = 0.002) in the 24 patients who were 10 years old or over. The factors related to a negative survival were male gender (<I>p</I> = 0.031) and an initial WBC of 10, 000/μl or more (<I>p</I> = 0.0012) in 43 patients. The major toxicities of the therapy were pancreatitis and allergic reaction due to L-ASP administration, and growth hormone deficiency due to cranial irradiation. Tokai 8610HR pilot protocol was a promising regimen, but further intensive chemotherapy was needed for improvement of the prognosis of the older patients with high initial WBC greater than 10, 000/μl.
- 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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