scholarly journals Brief Report: Effect of Intravenous Methotrexate Dose and Infusion Rate on Neuropsychological Function One Year after Diagnosis of Acute Lymphoblastic Leukemia

2006 ◽  
Vol 32 (2) ◽  
pp. 189-193 ◽  
Author(s):  
M. E. Carey ◽  
M. J. Hockenberry ◽  
I. M. Moore ◽  
J. J. Hutter ◽  
K. R. Krull ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Infusion Rate ◽  
Lymphoblastic Leukemia ◽  
Neuropsychological Function ◽  
Methotrexate Dose ◽  
One Year

Bone Mineral Density, Fracture Risk and Avascular Bone Necrosis in Childhood Acute Lymphoblastic Leukemia; an Up-Date of the Prospective DUTCH ALL9 Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1962-1962
Author(s):  
Marry M. Van den Heuvel-Eibrink ◽  
Inge M. Van der Sluis ◽  
Bert A. Leeuw ◽  
Gaby Kardos ◽  
Lizet M. te Winkel ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Acute Lymphoblastic Leukemia ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Lymphoblastic Leukemia ◽  
Fracture Incidence ◽  
Rapid Decline ◽  
Mineral Density ◽  
Discontinuation Of Treatment ◽  
One Year

Abstract The high cumulative dose of dexamethasone, applied in the DCOG ALL9 protocol, prompted us to investigate the risk of osteoporosis, fractures and avascular necroses of bone (AVN) in children treated with acute lymphoblastic leukemia (ALL). Fracture risk and incidence of symptomatic AVN was assessed in 778 patients(482 boys, 297 girls), included in the ALL9 protocol since 1997. Total cumulative doses (TCD) of dexamethasone were 1370 mg/m2 and 1244 mg/m2 and of MTX 8.1g/m2 13.6g/m2 for NHR and HR patients respectively. No CNS-irradiation was applied. In children aged >3 years, lumbar spine bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXAscan), at diagnosis(T0), after 32 weeks(T1), at discontinuation of treatment at 109 weeks(T2), and one year after discontinuation of treatment(T3). Results were expressed as standard deviation scores (SDS). Symptomatic AVN was defined as on MRI confirmed AVN lesions in combination with non-vincristine related persistent pain in arms or legs. Fractures were reported in 82/778 (10.5%) patients. Most occurred after mild trauma. No difference was found in fracture incidence between boys and girls. BMD was measured in 387/427 (90.6%) eligible patients. Median BMD-SDS was significantly lower than zero at all times of evaluation, the lowest BMD values were found at T2 (−1.47 SDS). Fracture risk was 3.9 times higher as compared to healthy school children. Fracture incidence was correlated with BMD at T2 and T3(p=0.04 and p=0,04 respectively), but not at T0 and T1. A significant more rapid decline in BMD from T0 to T2 and to T3 was seen in patients with fractures as compared to patients without fractures. After discontinuation of therapy, BMD recovered faster in cases without fractures. Symptomatic AVN occurred in 33/778 (4.2%) of our patients (med age 14, range 6,5–18 years) showing irreversibility in 22 % of the cases. Differences found in the incidence between the centers may suggest underestimation of the risk of fractures and AVN in this prospective study. Children with ALL show a significantly increased fracture risk. Patients with a more severe reduction in BMD during treatment are more susceptible to fractures. The AVN incidence in this protocol did not exceed previous reports of prednisolone-based protocols.

Immunophenotypic Pattern and Treatment Outcome after Completion of Induction Remission in Children with Acute Lymphoblastic Leukemia

2021 ◽  
Vol 8 (1) ◽  
pp. 59-64
Author(s):  
Farah Diba ◽  
Md. Anwarul Karim ◽  
Shahinoor Akter Soma ◽  
Indira Chowdhury ◽  
Showkat Mamun ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Acute Lymphoblastic Leukemia ◽  
T Cell ◽  
Complete Remission ◽  
B Cell ◽  
Lymphoblastic Leukemia ◽  
Induction Failure ◽  
One Year ◽  
Wbc Count ◽  
Medical University

Background: Acute lymphoblastic leukemia (ALL) is presented with different immunophenotypic pattern. Objective: The purpose of the study was to evaluate the immunophenotypic pattern of ALL and also, to recognize the frequency of different ALL subtypes and treatment outcome after induction remission therapy. Methodology: This prospective study was conducted in the Department of Paediatric Hematology and Oncology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from June 2017 to July 2018 for a period of one year. Newly diagnosed admitted cases of ALL aged 1 to 17.9 years were included. Immunophenotyping from aspirate marrow samples were done in a special hematology laboratory. Patients were monitored during induction remission period with physical examination and required investigations. Result: Among 87 analyzed patients, 81 patients (93.1%) were B-cell ALL and 6 patients (6.9%) were T-cell ALL. After completion of induction remission therapy 61 patients had undergone complete remission and among them B cell ALL were 56(69.1%) and T cell were 5(83.3%) (P=0.464). None of the patient had partial response or induction failure. Complication were developed in 53(60.91%) patients during induction therapy. Most common cause of death was septicemia (22/26). Death was more in patients who had total WBC count >50X109/L (p=0.017) and received regimen B (p=0.031). Conclusion: B cell ALL was more common and most of the patients had undergone complete remission after induction remission therapy. Journal of Current and Advance Medical Research, January 2021;8(1):59-64

Outcomes of Hematopoietic Stem Cell Transplantation for Childhood Acute Lymphoblastic Leukemia with t(4;11)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4502-4502
Author(s):  
Yuko Sekiya ◽  
Atsushi Narita ◽  
Nao Yoshida ◽  
Kimikazu Matsumoto ◽  
Koji Kato
Keyword(s):  
Stem Cell ◽  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Lymphoblastic Leukemia ◽  
Hematopoietic Stem ◽  
Childhood All ◽  
Allogeneic Hsct ◽  
One Year

Abstract Abstract 4502 Introduction: As the prognosis of childhood acute lymphoblastic leukemia (ALL) with t(4;11) is generally poor, hematopoietic stem cell transplantation(HSCT) at 1st complete remission is recommended in most of Japanese ALL protocol. We analyzed outcomes of HSCT for childhood ALL with t(4;11) at our department, and assessed the outcomes with age and preconditioning at HSCT. Subjects: We retrospectively analyzed 15 patients who underwent HSCT between 1991 and 2011. The onset of ALL was less than one year old (infant ALL) in 9 patients and over one year old in 6 patients. The disease status at HSCT was 1st complete remission (CR1) in 10 patients, 2nd complete remission (CR2) in 2 patients, and more advanced stages in 3 patients. 13 patients underwent allogeneic HSCT and 2 patients underwent autologous HSCT at median age of 19 months. In allogeneic HSCT, the number of bone marrow transplantation from HLA matched sibling was 3 and 4 from unrelated donors, and that of cord blood transplantation was 6. Nine patients including 7 infant ALL underwent conventional stem cell transplantation (CST), 6 patients including one infant ALL underwent reduced intensity stem cell transplantation (RIST). Preconditioning of RIST was mostly consisted of fludarabine and melphalan with 3Gy of total body irradiation (TBI). Results: Of all 15 patients, 8 patients are alive in CR. Three out of 9 infant ALL and 5 out of 6 ALL patients, whose onset was above 1 year old, are alive in CR. Seven of 10 ALL patients who underwent HSCT in 1st CR are alive, on the other hand, only one of 5 patients in 2nd CR or non CR is alive. Five patients who underwent RIST over 1 year old are alive in CR. Discussion: HSCT for childhood ALL with t(4;11) in 1st CR could achieve better outcome than those in 2nd CR or non CR. The transplant outcomes with RIST was better than CST and it could be applied for ALL patients with t(4;11) whose onset is over one year old. Disclosures: No relevant conflicts of interest to declare.

Extreme Tooth Abnormalities and Treatment under General Anesthesia in a Child with chronic GVHD Surviving Relapse of Acute Lymphoblastic Leukemia

2012 ◽  
Vol 37 (2) ◽  
pp. 199-201 ◽  
Author(s):  
S Maeda ◽  
M Suda ◽  
M Ishii ◽  
Y Tomoyasu ◽  
H Higuchi ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
General Anesthesia ◽  
Dental Treatment ◽  
Lymphoblastic Leukemia ◽  
Chronic Gvhd ◽  
Term Treatment ◽  
Permanent Teeth ◽  
Dental Abnormalities ◽  
Long Term Treatment ◽  
One Year

Treatment for acute lymphoblastic leukemia (ALL) mainly consists of chemotherapy, irradiation and bone marrow transplantation. In terms of long-term treatment effects, dental abnormalities and chronic graft-versus host disease (GVHD) are problems. We present a patient surviving relapse of ALL at one year of age. He had extreme dental abnormalities and multiple caries. Most of his permanent teeth were abnormal, and multiple caries were observed. Since he had a strong vomiting reaction to dental treatment, general anesthesia was given. During the general anesthesia, much sputum was aspirated because of chronic GVHD. His dental condition was worse than other cases reported previously. Since the survival rate has increased recently, the dental effects of ALL treatment have become significant. Especially, in patients undergoing total body irradiation at under 2 years of age, it is highly likely that dental problems will occur in the future.

scholarly journals Impact of Obesity on Lumbar Puncture Outcomes in Adults with Acute Lymphoblastic Leukemia and Lymphoma: Experience at an Academic Reference Center

2019 ◽  
Author(s):  
José Carlos Jaime-Pérez ◽  
Guillermo Sotomayor-Duque ◽  
Patrizia Aguilar-Calderón ◽  
Lorena Salazar-Cavazos ◽  
David Gómez-Almaguer
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lumbar Puncture ◽  
Lymphoblastic Leukemia ◽  
First Year ◽  
Lymphoid Malignancies ◽  
Non Hodgkin Lymphoma ◽  
Cns Relapse ◽  
The Central Nervous System ◽  
One Year

Background: Lumbar puncture (LP) is a hematology procedure that can require repeated attempts leading to traumatic LP (TLP), which has been related to the central nervous system (CNS) relapse. LP success can depend on the size and anatomy of the patient and the skill of the hematologist. The main objective was to determine the influence of body mass index (BMI) on LP outcomes. Materials and Methods: Adults with lymphoid malignancies requiring LP were included prospectively over one year; hematology residents performed most procedures. A 22-gauge Quincke needle was employed. Comparison between non-traumatic vs. traumatic LPs according to BMI, CNS relapse, and residents’ year was performed. Results: Fifty-four patients with a mean age of 31.5±15.57 years were included. Diagnosis was Acute Lymphoblastic Leukemia-B (74%), Acute Lymphoblastic Leukemia-T (13%) and Non-Hodgkin Lymphoma (13%). 227 LPs were performed, 121 (53.3%) successful, 98 (43.2%) traumatic, 11 (11.2%) TLPs were macroscopically detectable and 87 (88%) microscopic; 8 (3.5%) were dry-taps. Median time between punctures was 11 days (1-202). Median BMI was 25 (22.8-39.6). Main indication for LP was prophylactic (74.5%); 39.2% were performed by first-year, 35.2% by second-year, 19.6% by third-year hematology residents. No difference (p = 0.145) for a TLP was found among residents. A BMI ≥30 (p = 0.040), non-palpable intervertebral space (p = 0.001) and more than one attempt (p = 0.001) were significant for TLP. TLP was not associated with CNS relapse (p = 0.962). Conclusion: Obesity predicted a TLP. A traumatic puncture did not increase the risk of CNS relapse at one-year follow-up.

Metastatic Melanoma (Secondary Malignancy) after Recovery from Acute Lymphoblastic Leukemia in a 10-year-old Girl: a case report

2019 ◽  
Author(s):  
Saeed Yousofian ◽  
Ghasem Miri-Aliabad ◽  
Tahere Rostami ◽  
Mitra Mehrazma ◽  
Pardis Nematollahi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Malignant Neoplasm ◽  
Secondary Malignancy ◽  
Iranian Child ◽  
Cell Acute Lymphoblastic Leukemia ◽  
Secondary Malignant Neoplasm ◽  
One Year ◽  
Scalp Biopsy ◽  
Common Malignancy

Acute lymphoblastic leukemia is the most common malignancy in children with a 5-year survival rate, accounting for 80% of cases. Melanoma is rare in children and has been reported as a sporadically occurring secondary malignant neoplasm in children with acute lymphoblastic leukemia. This study presented a 10-year-old Iranian child with pre-B-cell acute lymphoblastic leukemia that was diagnosed at age 6. She was fully recovered after 2 years of treatment. One year and six months after cessation of treatment, she was referred  with a 1×2 cm mass in her right parietal region of scalp. Biopsy of the lesion confirmed the diagnosis of malignant melanoma. Computed tomography scan of the chest and abdomen also confirmed extensive liver metastasis which was corroborated by liver biopsy. Bone scan also revealed bone metastases. Early diagnosis and treatment of these tumors is extremely important and these patients should be closely monitored and undergo regular physical examination.

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