Combination Therapy for Childhood Acute Lymphocytic Leukemia

Abstract

This study for previously untreated childhood acute lymphocytic leukemia, conducted from April 1981 to November 1983, included 91 patients divided in two distinct groups, according to clinical and laboratory features at diagnosis. The standard risk group consisted of 64 patients, while the high risk group had 27 patients. The therapy differed according to the risk group. The following are the results for the standard risk and high risk groups, respectively: (1) early death rate, 7.8% and 26%; (2) induction of complete marrow remission, 97% and 90%; (3) incidence of CNS leukemia, 16% and 25%; and (4) overall relapse rate, 49% and 78%. These results indicate that, for the standard risk patients, the degree of success is parallel to current results from most series, and that the failure rate for the patients in the high risk group is extremely high. Early deaths may be avoided by prompt treatment and by an increase in the intensity of therapy to the highest tolerable levels for the patients with high risk features. Attempts to improve the outcome also for standard risk patients may be carried out through changes in therapy, aiming at enhancing their chances for leukemia-free survival.

Single-Arm Standard-Dosage Combination Chemotherapy for Childhood Acute Lymphocytic Leukemia (All-KFSH-84 Protocol)

“…1 These figures, mainly for the high-risk group, were very high and indicated that the effectiveness of prevention of central nervous system leukemia, according to the designs of the protocol, was inadequate.…”

“…1 The complete remission rate obtained was 97% (57 out of 59 patients) for the standard-risk group, and 90% (18 out of 20 patients) for the high-risk group.…”

Improved Outcomes of Childhood Acute Lymphoblastic Leukemia: A Retrospective Single Center Study in Saudi Arabia

“…For example, Middle East Childhood Cancer Alliance (MECCA) and the Saudi Arabian Pediatric Hematology/Oncology Society (SAPHOS) have conducted collaborative studies prospectively as well as retrospectively to collect data, which would serve as the basis for the subsequent clinical studies. Many single center/institutional studies have also been conducted to assess patients' characteristics and outcome of childhood ALL in KSA and to compare survival with respect to developed countries (Al-Nasser et al, 2008;Aur et al, 1985;Khalil et al, 1994). The present study is another addition to the efforts towards improving outcome of childhood ALL in KSA.…”

Allogenic Stem Cell Transplantation and Total Body Irradiation

“…Successful bone marrow transplantation with a combination of cyclophosphamide and total body irradiation as a conditioning regimen was first reported in the 1970s. [3] occurrence of engraftment, acute and chronic graftversus-host disease with BU/CY, but had higher rates of cataract, interstitial pneumonitis, later growth or developmental problems.…”