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Titolo:
Delay of the diagnostic lumbar puncture and intrathecal chemotherapy in children with acute lymphoblastic leukemia who undergo routine corticosteroidtesting: Tokyo Children's Cancer Study Group study L89-12
Autore:
Manabe, A; Tsuchida, M; Hanada, R; Ikuta, K; Toyoda, Y; Okimoto, Y; Ishimoto, K; Okawa, H; Ohara, A; Kaneko, T; Koike, K; Sato, T; Sugita, K; Bessho, F; Hoshi, Y; Maeda, M; Kinoshita, A; Saito, T; Tsunematsu, Y; Nakazawa, S;
Indirizzi:
Univ Tokyo, Inst Med Sci, Dept Pediat Hematol Oncol, Minato Ku, Tokyo 1088639, Japan Univ Tokyo Tokyo Japan 1088639 ol Oncol, Minato Ku, Tokyo 1088639, Japan Univ Tokyo, Dept Pediat, Tokyo, Japan Univ Tokyo Tokyo JapanUniv Tokyo, Dept Pediat, Tokyo, Japan Tokyo Childrens Canc Study Grp, Tokyo, Japan Tokyo Childrens Canc Study Grp Tokyo Japan Canc Study Grp, Tokyo, Japan Juntendo Univ, Dept Pediat, Tokyo, Japan Juntendo Univ Tokyo JapanJuntendo Univ, Dept Pediat, Tokyo, Japan Tokyo Med & Dent Univ, Dept Pediat, Tokyo, Japan Tokyo Med & Dent Univ Tokyo Japan Dent Univ, Dept Pediat, Tokyo, Japan Tokyo Metropolitan Kiyose Childrens Hosp, Dept Hematol Oncol, Tokyo, JapanTokyo Metropolitan Kiyose Childrens Hosp Tokyo Japan ncol, Tokyo, Japan Jikei Univ, Dept Pediat, Tokyo, Japan Jikei Univ Tokyo JapanJikei Univ, Dept Pediat, Tokyo, Japan Keio Univ, Dept Pediat, Tokyo, Japan Keio Univ Tokyo JapanKeio Univ, Dept Pediat, Tokyo, Japan Natl Childrens Hosp, Dept Environm Epidemiol, Tokyo 154, Japan Natl Childrens Hosp Tokyo Japan 154 Environm Epidemiol, Tokyo 154, Japan Natl Childrens Hosp, Dept Hematol, Tokyo 154, Japan Natl Childrens Hosp Tokyo Japan 154 Hosp, Dept Hematol, Tokyo 154, Japan Ibaraki Childrens Hosp, Dept Pediat, Mito, Ibaraki, Japan Ibaraki Childrens Hosp Mito Ibaraki Japan t Pediat, Mito, Ibaraki, Japan Saitama Childrens Med Ctr, Dept Hematol Oncol, Iwatsuki, Saitama, Japan Saitama Childrens Med Ctr Iwatsuki Saitama Japan watsuki, Saitama, Japan Yokohama City Univ, Dept Pediat, Yokohama, Kanagawa 232, Japan Yokohama City Univ Yokohama Kanagawa Japan 232 ohama, Kanagawa 232, Japan Kanagawa Childrens Med Ctr, Dept Oncol, Yokohama, Kanagawa, Japan KanagawaChildrens Med Ctr Yokohama Kanagawa Japan hama, Kanagawa, Japan Chiba Childrens Hosp, Dept Hematol Oncol, Chiba, Japan Chiba Childrens Hosp Chiba Japan Hosp, Dept Hematol Oncol, Chiba, Japan Chiba Univ, Dept Pediat, Chiba, Japan Chiba Univ Chiba JapanChiba Univ, Dept Pediat, Chiba, Japan Shinshu Univ, Dept Pediat, Matsumoto, Nagano 390, Japan Shinshu Univ Matsumoto Nagano Japan 390 iat, Matsumoto, Nagano 390, Japan Yamanashi Med Univ, Dept Pediat, Kofu, Yamanashi, Japan Yamanashi Med Univ Kofu Yamanashi Japan t Pediat, Kofu, Yamanashi, Japan
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 13, volume: 19, anno: 2001,
pagine: 3182 - 3187
SICI:
0732-183X(20010701)19:13<3182:DOTDLP>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
CRANIAL RADIOTHERAPY; TRIAL; ALL-BFM-86; RELAPSE; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
10
Recensione:
Indirizzi per estratti:
Indirizzo: Manabe, A Univ Tokyo, Inst Med Sci, Dept Pediat Hematol Oncol, Minato Ku, 4-6-1 Shirokanedai, Tokyo 1088639, Japan Univ Tokyo 4-6-1 Shirokanedai Tokyo Japan 1088639 088639, Japan
Citazione:
A. Manabe et al., "Delay of the diagnostic lumbar puncture and intrathecal chemotherapy in children with acute lymphoblastic leukemia who undergo routine corticosteroidtesting: Tokyo Children's Cancer Study Group study L89-12", J CL ONCOL, 19(13), 2001, pp. 3182-3187

Abstract

Purpose: To determine the effects of eliminating initial lumbar punctures in 418 consecutively treated children with acute lymphoblastic leukemia (ALL). Patients and Methods: Patients were enrolled onto a trial conducted in central Japan between 1989 and 1992. Treatment consisted of standard four-druginduction therapy followed by a risk-based intensification phase, reinduction therapy, late intensification, and remission maintenance therapy (totalof 104 weeks). The initial lumbar puncture, with an intrathecal injection of chemotherapy, was performed after 1 week of prednisolone sensitivity testing (day 8). End points included response to prednisolone, CNS status at the time of the day 8 lumbar puncture, subsequent adverse events in CNS and bone marrow, and event-free survival (EFS). Results: The remission induction rate was 93.1% with a 6-year EFS rate (+/- SE) of 68.7% +/- 2.4%, which is similar to historical results for patients who received their-diagnostic lumbar puncture and first instillation of intrathecal chemotherapy on day 0. Overall, 84.5% of the patients had good responses to prednisolone, whereas 15.5% had poor responses. Clinical outcome was strikingly better for the good responders (6-year EFS, 74.1% +/- 2.5%compared with 40.1% +/- 6.4% for patients with poor responses), suggestingthat omission of intrathecal chemotherapy did not alter the predictive value of drug sensitivity testing. Eighteen patients experienced CNS relapse as their first adverse event (cumulative risk, 5.1%; 95% confidence interval, 2.7% to 7.4%), coincident with reports from groups using conventional strategies of CNS clinical management. Bleeding into the CSF at the time of the day 8 lumbar puncture was apparent in 29 cases (8.1%), but leukemic blasts were identified in only two. Conclusion: Delay of the initial lumbar puncture and intrathecal injectionof chemotherapy seems to be feasible in children with ALL. Further controlled evaluations are needed to establish the validity of this conclusion. (C) 2001 by American Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 00:57:05