Treatment of an Isolated Central Nervous System Relapse of Childhood Acute Lymphoblastic Leukemia.
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概要
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Since the 1960s, intrathecal therapy with or without cranial irradiation in combination with systemic chemotherapy has greatly contributed to reduce the incidence of central nervous system (CNS) recurrence in acute lymphoblastic leukemia (ALL) in children. However, CNS recurrence has continued to be still observed in approximately 5-10% of patients. We report 4 children with an isolated CNSrelapse of ALL, diagnosed from 1986 to 1993. All except one were initially treated with standard risk regimen, including high-dose methotrexate (MTX) infusion and intrathecal medication without cranial irradiation. Thelength of first remission ranged from 24 to 56 months. All patients achieved second remission by triple-drug intrathecal medication combined with high-risk ALL-oriented systemic chemotherapy followed by radiation therapy. Second, a CNS relapse occurred in two cases 17 and 84 months later, respectively. To one of them, melphalan and total body irradiation with purged marrow rescue was carried. As a result, all 4 patients are alive in complete remission.
- 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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