The impact of acute lymphoblastic leukemia treatment on central nervous system results in Bogota, Colombia

To improve the outcome of children with acute lymphoblastic leukemia (ALL) treated at the National Cancer Institute, Bogota, Colombia, a protocol based on the BFM-90 (Berlin, Frankfurt, Munster study) and the LSA2L 2 regimens was implemented in the year 1993. The patients were classified as being standard risk (SR) or high risk (HR) according to clinical criteria, to which cytogenetic information and day-8 prednisone response were also added. A 123-patient cohort entered the study, 18 of them being considered SR and 105 HR. There was a 94% 10 years' event-free-survival rate for the SR group and 36% for the HR group. Decreased induction death rate (7% vs. 14%), increased complete remission (CR) rate (81% vs. 75%), and continuous CR (45% vs. 33%) were found in comparison with the previous study. A significant improvement was achieved in relapse rate, 44% to 28% (P=0.029), mainly due to reduced central nervous system relapse rate from 16% to 6% (P=0.037), whereas the number of patients receiving cranial radiation was reduced to 55%. A major problem concerned the increased CR mortality rate, 5% to 14% (P=0.06). Improved supportive care therapy and socioeconomic conditions will hopefully reduce the CR mortality rate in the future. © 2008 by Lippincott Williams and amp; Wilkins.

• Fecha de publicación: 2008
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/22419
• Acceso en línea: https://doi.org/10.1097/MPH.0b013e31817e4a7d; https://repository.urosario.edu.co/handle/10336/22419
• Palabra clave: Antineoplastic agent; Asparaginase; Cyclophosphamide; Cytarabine; Daunorubicin; Dexamethasone; Doxorubicin; Folinate calcium; Mercaptopurine; Methotrexate; Prednisone; Acute lymphoblastic leukemia; Adolescent; Article; Cancer chemotherapy; Cancer mortality; Cancer radiotherapy; Cancer regression; Cancer relapse; Cancer risk; Cancer survival; Central nervous system; Child; Colombia; Controlled study; Cytogenetics; Drug dose reduction; Drug megadose; Female; Human; Infant; Major clinical study; Male; Multiple cycle treatment; Preschool child; Priority journal; School child; Treatment outcome; Treatment response; Adolescent; Antineoplastic combined chemotherapy protocols; Central nervous system neoplasms; Child; Cohort studies; Colombia; Cranial irradiation; Cytogenetic analysis; Humans; Infant; Precursor cell lymphoblastic leukemia-lymphoma; Prednisone; Recurrence; Remission induction; Risk; Survival rate; Cns-leukemia; Developing country; Intensive chemotherapy; Pediatric all; preschool; Child
• License: Abierto (Texto Completo)