The survival period of children suffering from leukemia could be prolonged by using the new antileukemic agents. On the other hand, the frequency of central nervous system involvement as a complication of this disease was very high, i.e. 10 of 19 cases. Six showed signs of meningeal leukemia while they were in hematologic remission and the other 4 were within acute stage. Nine children were given methotrexate intrathecally as a prophylactic measure at the time when diagnosis of leukemia was confirmed, and did not suffer from this complication during follow-up to 6–13 months. From these data we conclude that the regular administration of methotrexate intrathecally to leukemic patients as a prophylactic measure, with routine spinal fluid examinations, is very useful in preventing or in reducing the central nervous system involvement.
The first Hb S (Hb S trait) inIndonesia, was found by Lie-InjoLuan Eng (1956) in Jakarta. Asfar as we know the case presentedin this paper, is the first patient withthalassemia-Hb S disease ever foundin the Indonesian literature.
A comparison was made between the results of splenectomy performed on 19 children with thalassemia major, who were operated on after the signs of hypersplenism and hemosiderosis appeared, and on 25 children (11 with thalassemia Hb E disease and 14 with thalassemia major), who splenectomized indication of increased blood requirement only, before signs of hypersplenism or hemosiderosis appeared.From the results, it can be concluded that splenectomy should be performed as soon as increased transfusion requirement appears, before hypersplenism Or hemosiderosis becomes apparent. Due to high frequency of postsplenectomy infections, it is still preferable to operate the child after 2 years of age.
The present report describes leu-kemic infiltration of the testes in a6 1/2-year-old boy suffering from acu-te lymphoblastic leukemia duringbone marrow and hematologic remis-Sion.
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