scholarly journals Remission induction with cytosine arabinoside and L-Asparaginase in acute lymphoblastic leukaemia

BMJ ◽  
1969 ◽  
Vol 4 (5683) ◽  
pp. 596-598 ◽  
Author(s):  
T. J. McElwain ◽  
R. M. Hardisty
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Lymphoblastic Leukaemia ◽  
Cytosine Arabinoside ◽  
Remission Induction

Unbalanced Coagulation-Fibrinolysis Potential during L-Asparaginase Therapy in Children with Acute Lymphoblastic Leukaemia

1990 ◽  
Vol 64 (01) ◽  
pp. 038-040 ◽  
Author(s):  
N Semeraro ◽  
P Montemurro ◽  
P Giordanol ◽  
F Schettini ◽  
N Santoro ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Induction Therapy ◽  
Lymphoblastic Leukaemia ◽  
Mononuclear Cells ◽  
Thrombus Formation ◽  
Chemotherapeutic Agents ◽  
Remission Induction ◽  
Concurrent Administration ◽  
Peripheral Blood Mononuclear ◽  
Thrombotic Complications

SummaryTreatment of acute lymphoblastic leukaemia (ALL) with L-asparaginase (L-asp) may be associated with thrombotic complications, but the pathogenetic mechanisms of thrombus formation and persistence remain unclear. We studied the procoagulant activity (PCA) of peripheral blood mononuclear cells and some components of the plasma fibrinolytic system in L0 children with ALL undergoing remission induction therapy which includes L-asp. Mononuclear cells obtained 14 days after starting L-asp treatment generated significantly higher amounts of PCA (identified as tissue factor) than cells isolated before the first dose of L-asp and 7 days after the cessation of L-asp administration (p <0.01). Augmented PCA coincided with an increase in the plasma D-dimer. The plasma levels of type 1- plasminogen activator inhibitor were found signiticantly elevated during L-asp therapy (p <0.05), whereas plasminogen levels were markedly decreased (p <0.05). These findings suggest that, during the course of L-asp treatment, the coagulation-fibrinolysis balance is shifted towards promotion of fibrin formation and deposition. Although it remains to be conclusively established whether Lasp per se or the concurrent administration of multiple chemotherapeutic agents is responsible for these changes, the latter could contribute to the thrombotic complications associated with remission induction therapy for ALL.

scholarly journals Treatment abandonment in childhood acute lymphoblastic leukaemia in China: a retrospective cohort study of the Chinese Children’s Cancer Group

2019 ◽  
Vol 104 (6) ◽  
pp. 522-529 ◽  
Author(s):  
Jiaoyang Cai ◽  
Jie Yu ◽  
Xiaofan Zhu ◽  
Shaoyan Hu ◽  
Yiping Zhu ◽  
...  
Keyword(s):  
High Risk ◽  
Acute Lymphoblastic Leukaemia ◽  
Low Income ◽  
Lymphoblastic Leukaemia ◽  
Laboratory Data ◽  
Remission Induction ◽  
Chinese Government ◽  
Current Frequency ◽  
Cancer Group ◽  
Treatment Abandonment

ObjectivesBefore 2003, most children with acute lymphoblastic leukaemia (ALL) abandoned treatment, with only approximately 30% treated in China. With the development of national insurance for underprivileged patients, we assessed the current frequency and causes of treatment abandonment among patients with ALL who were enrolled in the Chinese Children’s Cancer Group ALL protocol between 2015 and 2016.MethodsDemographic, clinical and laboratory data on patients who abandoned treatment, as well as economic and sociocultural data of their families were collected and analysed. General health-related statistics were retrieved from publicly accessible databanks maintained by the Chinese government.ResultsAt a median follow-up of 119 weeks, 83 (3.1%, 95% CI 2.5% to 3.8%) of the 2641 patients abandoned treatment. Factors independently associated with abandonment included standard/high-risk ALL (OR 2.62, 95% CI 1.43 to 4.77), presence of minimal residual disease at the end of remission induction (OR 3.57, 95% CI 1.90 to 6.74) and low-income economic region (OR 3.7, 95% CI 1.89 to 7.05). According to the family members, economic constraints (50.6%, p=0.0001) were the main reason for treatment abandonment, followed by the belief of incurability, severe side effects and concern over late complications.ConclusionsThe rate of ALL treatment abandonment has been greatly reduced in China. Standard/high-risk ALL, residence in a low-income region and economic difficulties were associated with treatment abandonment.Clinical trial registration numberChiCTR-IPR-14005706, pre-results.

scholarly journals Successful outcome of disseminated Candida tropicalis osteomyelitis on remission induction for childhood Philadelphia chromosome–positive acute lymphoblastic leukaemia-case report

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Lichun Xie ◽  
Qingling Long ◽  
Guichi Zhou ◽  
Sixi Liu ◽  
Fei-Qiu Wen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Acute Lymphoblastic Leukaemia ◽  
Candida Tropicalis ◽  
Lymphoblastic Leukaemia ◽  
Philadelphia Chromosome ◽  
Remission Induction ◽  
Resonance Imaging ◽  
Successful Management ◽  
All Treatment

Abstract Background Invasive fungal infection (IFI) is one of the most challenging complications in children undergoing acute lymphoblastic leukaemia (ALL) treatment, but acute fungal osteomyelitis (OM) is rarely encountered. Case presentation Here, we describe a case of Candida tropicalis osteomyelitis in a 10-year-old patient with Philadelphia chromosome (Ph)-positive ALL. He was on remission induction therapy at the time of neutropenia, and an abscess developed in his right arm. The blood and bone cultures were positive for C. tropicalis. Antibiotics and antifungals were administered. Magnetic resonance imaging of the arm revealed an intraosseous abscess, suggestive of OM. Surgical irrigation and debridement of the bone were performed immediately. The patient was effectively treated with antifungal therapy and ALL treatment. He has fully recovered into complete clinical remission but with visible sequelae on magnetic resonance imaging (MRI). He took oral posaconazole for consolidation until disappearance of the lesion shadows on MRI and received subsequent cycles of chemotherapy in parallel. Conclusions In the successful management of Ph-positive ALL, dasatinib, a second-generation Abl-tyrosine kinase inhibitor, is crucial. The recommended treatment for Candida osteomyelitis in Ph-positive ALL patients is a fungicidal agent combined with surgery and modification chemotherapy with dasatinib. The use of combined modalities of treatment seems to be crucial in the successful management of Ph-positive ALL.

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