Mediastinal mass in acute lymphoblastic leukemia

Chilcote, Robert R.; Coccia, Peter F.; Sather, Harland N.; Robison, Leslie L.; Baehner, Robert L.; Nesbit, Mark E.; Hammond, Denman

doi:10.1002/mpo.2950120105

Cited by 20 publications

(7 citation statements)

References 39 publications

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“…When multivariate analysis for significant independent variables to predict disease-free survival was employed, mediastinal mass and central nervous system disease at diagnosis were not significant indicators in the present or in other studies (3,14).…”

Section: Lymphoblast Type T O R Bcontrasting

confidence: 61%

Prognostic factors for relapse‐free survival in childhood acute lymphoblastic leukaemia

Clausen

Scheibel

Nyboe

1984

Scandinavian Journal of Haematology

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11 variables determined at the onset of acute lymphocytic leukaemia were tested to predict disease‐free survival in 267 children. All children had received similar induction treatment and basic maintenance therapy, whereas 5 different reinforcement treatments were administered irrespective of the severity of the disease at onset. Three modes of prophylactic central nervous system treatment were employed. The risk of relapse was significantly increased for leucocyte count above 50 times 109/1, lymphoblasts above 80% in peripheral blood, age below 2 years or over 5 years, and for males. The risk of relapse was increased by estimated factors of 1.9, 2.3, 1.7, and 1.7, respectively. When the above 4 variables were included in the model, no further prognostic value was demonstrated for haemoglobin concentration, platelet count, signs of bleeding in the skin, mucous membranes or intracranially, presence of leukaemic infiltrations outside the bone marrow, hepatosplenomegaly, mediastinal mass, or T‐ or B‐cell leukaemia. However, evaluation of T‐ or B‐lymphoblast type impact was hampered by small numbers.

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Section: Lymphoblast Type T O R Bcontrasting

confidence: 61%

Prognostic factors for relapse‐free survival in childhood acute lymphoblastic leukaemia

Clausen

Scheibel

Nyboe

1984

Scandinavian Journal of Haematology

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“…[7][8][9][10] Mediastinal mass has received a great deal of attention, and therapeutic trials have been specially designed to challenge its presence. [11][12][13][14] Mediastinal mass is usually associated with T-cell ALL as determined by the E + rosette formation test and detection of T-cell antigens. If the patients who died early and received insufficient induction therapy are excluded, the remission rates for our standard risk patients receiving the 3-drug-schedule and high risk patients receiving the 4-drug-schedule (Tables 1 and 2) were quite high: 97% and 90% respectively.…”

Section: Discussionmentioning

confidence: 99%

Combination Therapy for Childhood Acute Lymphocytic Leukemia

et al. 1985

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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.

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“…These masses can occur in the middle or posterior mediastinal cavity but usually result from blastcells infiltrating the anterior mediastinal structures (e.g., thymus). These blast cells-usually T cells and not B cells-can invade bone marrow and the thymus, thus decreasing the total red blood cell count as well as hemoglobin level (1,2). Mediastinal masses are often associated with a high peripheral white blood cell count and usually disappear after treatment with radiation and chemotherapy (1).…”

Section: Discussionmentioning

confidence: 99%