Central nervous system relapse prophylaxis in acute lymphoblastic leukemia (ALL) intrathecal chemotherapy with and without cranial irradiation

Authors

  • Ahmad Tamaddoni
  • Hassan Mahmodi Nesheli
  • Mohammad Kazem Bakhshandeh Bali
Abstract:

Background: Central Nervous System (CNS) relapse in acute lymphoblastic leukemia was significantly decreased due to the use of new chemotherapyeutic agents, Intrathecal chemotherapy and cranial irradiation. The purpose of this study was to compare the effectiveness of intrathecal (IT) CNS chemotherapy alone versus combination of IT chemotherapy with cranial irradiation for prevention of CNS relapse.Methods: From 1998 to 2008 ninety eight cases of acute lymphoblastic leukemia (ALL) admitted in Amirkola Children Hospital were enrolled in this study. The chemotherapy regimen was on the basis of protocol of BFM-79. CNS prophylaxis consisted of intrathecal Cytarabin or Methotrexate, in addition to cranial irradiation for patients more than 3 years old. We assessed the incidence of CNC relapses over 10 years of CNS prophylaxis regimen. Results: From ninety eight cases, 53 were females and 45 were males. Twenty six were below 3 years old and seventy two were above 3 years old (p<0.05). For 10 years of study for the 72 cases who were more than 3 years old and had received prophylactic cranial irradiation CNS relapse did not happen. Among the 26 cases below 3 years old who didnot receive prophylactic cranial irradiation CNS relapse for one case happened (3.8%) (p<0.05). Conclusion: The results show that the combination of prophylactic CNS irradiation and intrathecal chemotherapy is effective in prophylaxis of CNS relapse in ALL.

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

central nervous system relapse prophylaxis in acute lymphoblastic leukemia (all) intrathecal chemotherapy with and without cranial irradiation

background: central nervous system (cns) relapse in acute lymphoblastic leukemia was significantly decreased due to the use of new chemotherapyeutic agents, intrathecal chemotherapy and cranial irradiation. the purpose of this study was to compare the effectiveness of intrathecal (it) cns chemotherapy alone versus combination of it chemotherapy with cranial irradiation for prevention of cns rel...

full text

Comparison of central nervous system prophylaxis with cranial radiation and intrathecal methotrexate versus intrathecal methotrexate alone in acute lymphoblastic leukemia.

In acute lymphoblastic leukemia (ALL), central nervous system (CNS) prophylaxis with cranial irradiation plus 5 doses of intrathecal methotrexate (i.t. MTX) reduces the incidence of CNS relapse to 7%-15%. However, increased evidence of CNS delayed toxicity started to be recognized as CT scan abnormalities and neuropsychologic alterations, mainly in children. Two questions were analyzed in the p...

full text

Early intensification of intrathecal chemotherapy virtually eliminates central nervous system relapse in children with acute lymphoblastic leukemia.

Central nervous system (CNS) relapse has been an obstacle to uniformly successful treatment of childhood acute lymphoblastic leukemia (ALL) for many years. We therefore intensified intrathecal chemotherapy (simultaneously administered methotrexate, hydrocortisone, and cytarabine) for 165 consecutive children with newly diagnosed ALL enrolled in Total Therapy Study XIIIA from December 1991 to Au...

full text

Efficacy and morbidity of central nervous system "prophylaxis" in childhood acute lymphoblastic leukemia: eight years' experience with cranial irradiation and intrathecal methotrexate.

Between 1972 and 1979, 214 children with acute lymphoblastic leukemia and no evidence of central nervous system (CNS) disease prior to CNS prophylaxis were treated with 2400 rad cranial irradiation and concurrent intrathecal methotrexate. Only nine children developed CNS leukemia; five of them in the CNS only and four concurrently in the CNS and another site. Major acute effects of CNS prophyla...

full text

Isolated Central Nervous System Relapse of Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most common form of childhood cancer and may exhibit central nervous system (CNS) involvement. Advances in chemotherapy and effective CNS prophylaxis have significantly decreased the incidence of CNS relapse of ALL to 5-10%. Here, we report the case of a patient with isolated CNS relapse of standard risk group pre-B-cell type ALL in an 11-year-old girl,...

full text

Combination chemotherapy of adult acute lymphoblastic leukemia with randomized central nervous system prophylaxis.

Although major progress has been made in the treatment of childhood leukemia, the optimal chemotherapy of acute lymphoblastic leukemia (ALL) in adults has been unclear. In addition, the value of central nervous system prophylaxis (CNS-P) in adults has been assumed, but not established in a systematic fashion. The Southeastern Cancer Study Group has completed a prospective study in which the use...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 1  issue None

pages  27- 30

publication date 2010-01

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023