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Download Central Nervous System Leukemia: Prevention and Treatment by R. A. Price (auth.), Renato Mastrangelo MD, David G. Poplack PDF

By R. A. Price (auth.), Renato Mastrangelo MD, David G. Poplack MD, Riccardo Riccardi MD (eds.)

In the prior 10 to IS years there was dramatic development within the survival of kids with acute lymphoblastic leukemia. today, over 50% of kids with this affliction might be alive and freed from their ailment a minimum of five years from the time in their preliminary prognosis. even though a couple of components have contributed to this development, maybe none has been as very important because the establishment of imperative worried approach preventive treatment (eNS prophylaxis). even if, regardless of the efficacy of eNS prophylaxis, the prevention and remedy of critical frightened method leukemia keeps to pose an impressive scientific problem to the pediatric oncologist. even though winning quite often, eNS preventive treatment continues to be useless for a small yet major subset of sufferers at excessive danger for constructing eNS sickness. furthermore, it has turn into more and more obtrusive that a few equipment of eNS preventive remedy are linked to long term, opposed eNS sequelae. therefore, enormous controversy exists in regards to the optimum approach to eNS prophylaxis. therapy of the sufferer who develops overt meningeal leukemia has now not been as profitable and keeps to pose an incredible scientific problem. regardless of the facility of intrathecal chemotherapy and/or radiation treatment to urge eNS remission, such a lot sufferers endure next relapse and supreme survival is mostly signifi­ cantly compromised. it truly is obtrusive that more moderen methods to therapy for this sufferer workforce needs to be pointed out ahead of significant development for this sufferer workforce is probably going to occur.

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7. Haghbin M, Murphy ML, Tan CC, Clarkson BD, Thaler HT, Passe S, Burchenal J: A long term clinical follow-up with acute lymphoblastic leukemia treated with intensive chemotherapy regimes. Cancer 46:241-282, 1980. 8. Sinks L, Wang JJ, Freeman AI: The treatment of primary childhood acute lymphocytic leukemia with intermediate dose Methotrexate. Modern trends in human leukemia IV. (Latest results in clinical biological research including pediatrics-oncology). Neth R, Gallo RC, Graf T, Mannweiler K, Winkler K (eds), Springer Verlag, 1981, p 107.

48 4. Bleyer WA: Central Nervous System prophylaxis: Children's Cancer Study Group results. This issue. 5. Hardisty RM: Prophylaxis of central nervous system leukemia: recent British experience. This issue. 6. Zuelzer WW, Ravindranath Y, Lusher JM, Sarnaik S, Considine B: IMFRA (Intermittent Intrathecal Methotrexate and Fractional Irradiation) plus chemotherapy in childhood acute leukemia. Am J Hematology 1:191-199, 1976. 7. Haghbin M, Murphy ML, Tan CC, Clarkson BD, Thaler HT, Passe S, Burchenal J: A long term clinical follow-up with acute lymphoblastic leukemia treated with intensive chemotherapy regimes.

This report compares the results to date of the various prophylactic regimes used in UKALL trials I-V, to which patients were entered between 1970 and 1979. Patients and methods The dates of entry to the various trials and the CNS irradiation dosages are shown in Table 1. Details of the radiotherapy and chemotherapy schedules have been previously published (2-5), except for UKALL IV; this was confined to patients with initial leucocyte counts over 20 x 10 9 /1, who were randomized to ind uction with COAP or with vincristine and prednisolone, and then to intermittent or continuous maintenance regimes.

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