scholarly journals Factors That Influence the Appearance of Central Nervous System Leukemia

Blood ◽  
1973 ◽  
Vol 42 (6) ◽  
pp. 935-938 ◽  
Author(s):  
Santiago Pavlovsky ◽  
Mariana Eppinger-Helft ◽  
Federico Sackmann Muriel
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Lymphocytic Leukemia ◽  
Treatment Protocol ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Cns Involvement ◽  
Lymphoid Leukemia ◽  
Myelocytic Leukemia ◽  
Wbc Count

Abstract At present, central nervous system (CNS) leukemia is one of the principal causes for termination of complete remission in acute lymphocytic leukemia (ALL). The factors which influence the increase of CNS infiltration have been studied comparing different parameters (age, initial peripheral WBC count, type of leukemia, and presence or absence of initial organomegaly) to determine the leukemia population with highest risk of developing this syndrome. A total of 127 cases of acute lymphoid leukemia (ALL) (98 children and 29 adults) and 101 acute myelocytic leukemia (AML) (41 children and 60 adults), on the same treatment protocol from 1967 to 1970, were included in this study. The median survival and the rate of incidence of symptomatic CNS leukemia was 18 mo and 32% in ALL and 4 mo and 7% in AML. The incidence of CNS leukemia per month of survival was similar in both groups: 4 mo, 3% in AML and 4% in ALL, at 8 mo, 13% in both ALL and AML. The incidence of CNS leukemia was higher in children with ALL than in adults: 41% in children and 19% in adults at 20-mo survival. Organomegaly (spleen, liver and/or lymph nodes) as an early manifestation increased the risk of CNS involvement. The CNS infiltration was significantly greater in patients with high initial peripheral WBC count. The incidence of meningeal leukemia did not differ in ALL and AML. In conclusion, CNS leukemia infiltration was more frequent in children with initial organomegaly and high WBC count at the time of diagnosis.

scholarly journals Central Nervous System Therapy and Combination Chemotherapy of Childhood Lymphocytic Leukemia

Blood ◽  
1971 ◽  
Vol 37 (3) ◽  
pp. 272-281 ◽  
Author(s):  
RHOMES J. A. AUR ◽  
JOSEPH SIMONE ◽  
H. OMAR HUSTU ◽  
THOMAS WALTERS ◽  
LUIS BORELLA ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Complete Remission ◽  
Combination Chemotherapy ◽  
Acute Lymphocytic Leukemia ◽  
Viral Infections ◽  
Combined Therapy ◽  
Lymphocytic Leukemia ◽  
Intrathecal Methotrexate ◽  
Central Nervous System Relapse

Abstract In earlier combination chemotherapy regimens for childhood acute lymphocytic leukemia, nervous system leukemia terminated complete remission in over half the patients in a median time of 11 months. In the present study, cranial radiation (2400 R, 60Co) and intrathecal methotrexate given early in remission were added to combination chemotherapy in an attempt to prevent or delay central nervous system relapse and termination of complete remission. Of 35 consecutive children with previously untreated acute lymphocytic leukemia, 20 of 30 who attained remission and received all initial phases of therapy have been in continuous complete remission for 23 to 30 months. Complete remission was terminated by nervous system relapse in three patients and by hematological relapse in five. Two patients died in complete remission of viral infections and others experienced reversible drug toxicity. We conclude that this combined therapy reduces the incidence of nervous system relapse in the first 2 years and prolongs complete remission.

Methotrexate Infusions as Central Nervous System Prophylaxis in Children with Acute Lymphocytic Leukemia: The Norwegian Experience

2003 ◽  
Vol 20 (3) ◽  
pp. 187-200
Author(s):  
Peter Johan Moe ◽  
Are Holen ◽  
Randi Nygaard ◽  
Anders Glomstein ◽  
Birgit Madsen ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Central Nervous System Prophylaxis

scholarly journals A Comparative Study of Two Regimens of Combination Chemotherapy in Acute Leukemia

Blood ◽  
1958 ◽  
Vol 13 (12) ◽  
pp. 1126-1148 ◽  
Author(s):  
EMIL FREI ◽  
JAMES F. HOLLAND ◽  
MARVIN A. SCHNEIDERMAN ◽  
DONALD PINKEL ◽  
GEORGE SELKIRK ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Survival Time ◽  
Median Survival ◽  
Combination Chemotherapy ◽  
Drug Toxicity ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Acute Myelocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Remission Status

Abstract A comparative clinical trial of two regimens of combination chemotherapy has been accomplished in acute leukemia by four separate medical and pediatric services. Sixty-five patients were allocated at random to one of two treatment programs. Daily administration of methotrexate with daily 6-mercaptopurine has been compared to methotrexate every third day in the same total dose with daily 6-mercaptopurine. No difference in frequency of remission, extent of remission or toxicity was observed between the two groups. Among those patients who attained remission status, however, duration of remission (P = .05-.10) and of survival (P = <.05) was longer for the continuous group. All remissions in children occurred in acute lymphocytic leukemia, whereas all remission in adults were observed in acute myelocytic leukemia. The duration of remissions was somewhat shorter for children with acute lymphocytic leukemia than for adults with acute myelocytic leukemia. The frequency of remission, either partial or complete, was higher in children, however (36 per cent), than in adults (19 per cent), although the confidence limits for each figure overlap. The duration of acute leukemia in previously untreated patients did not influence response to therapy from the two antimetabolite regimens in this study. In patients who had had prior antimetabolite therapy, however, complete remissions were attained less often than in previously untreated patients. The toxic manifestations encountered during the administration of these antimetabolites are described. Seventeen deaths occurred during this study, of which 8 occurred in the first 10 days, presumably from leukemia and not drug toxicity. Five patients died with hypoplastic marrows ascribed to drug toxicity. The toxic manifestations were qualitatively and proportionately the same in patients who attained remission status, and in those patients who failed to remit, but who lived long enough to recognize the onset of remission if it were going to occur. No indication was obtained, therefore, that patients who attained remission were subjected to a greater toxic hazard, in order to achieve the therapeutic benefits observed, than those who did not remit. The median survival of patients who achieved remission was longer (p <.05) than for patients who did not remit. Since the survival time of remitters from relapse to death was almost identical with the survival time of nonremitters from onset of treatment to death, this difference can be accounted for by the time spent in remission and getting to remission. The median survival time from symptomatic onset for all children in this study was 12 months, and for adults, 7 months. The median in children is similar to that reported from other clinics. This is evidence that a comparative therapeutic trial in acute leukemia can be accomplished without recognizable compromise of patient welfare.

Effects of Central-Nervous-System Irradiation on Neuropsychologic Functioning of Children with Acute Lymphocytic Leukemia

1975 ◽  
Vol 293 (3) ◽  
pp. 113-118 ◽  
Author(s):  
Sileen S. Soni ◽  
George W. Marten ◽  
Samuel E. Pitner ◽  
Danilo A. Duenas ◽  
Morris Powazek
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia
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