No abstract available.
Child* ; Drug Therapy* ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Child ; China ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Methotrexate(MTX) is currently one of the most important antineoplastic drugs used in chemotherapy. Intrathecal(IT) MTX is widely used to treat or prevent meningeal leukemia and lymphoma. Aseptic meningitis following IT MTX is not uncommon, but not reported frequently in neurological field. We report a case of aseptic meningitis following IT MTX in acute lymphocytic leukemia.
Antineoplastic Agents ; Drug Therapy ; Leukemia ; Lymphoma ; Meningitis, Aseptic* ; Methotrexate* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Childhood acute lymphoblastic leukemia (ALL) accounts for about 75% of childhood leukemia cases, and B-lineage acute lymphoblastic leukemia (B-ALL) accounts for more than 80% of childhood ALL cases. Over the past half century, new molecular biological targets discovered by new techniques have been used in precise stratification of disease prognosis, and there has been a gradual increase in the 5-year overall survival rate of childhood ALL. With the increasing attention to long-term quality of life, the treatment of childhood B-ALL has been constantly optimized from induction therapy to the intensity of maintenance therapy, including the treatment of extramedullary leukemia without radiotherapy, which has been tried with successful results. The realization of optimized treatment also benefits from the development of new techniques associated with immunology and molecular biology and the establishment of standardized clinical cohorts and corresponding biobanks. This article summarizes the relevant research on the implementation of precise stratification and the intensity reduction and optimization treatment of B-ALL in recent years, providing reference for clinicians.
Humans ; Quality of Life ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Prognosis ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Acute Disease

Acute lymphoblastic leukemia is the commonest pediatric malignancy caused by the disturbed differentiation of hematopoietic stem cells. Due to the effective measure of individualized therapy, the outcome of ALL therapy has been improved dramatically in recent decades. The reduction of treatment intensity in favorable patient groups decreases acute and long-term toxicity, only for the high-risk groups the intensive chemotherapy is of value, and the different therapies should be used, depending on their different biologic features.Even with intensive therapy or new drugs, the outcome of relapsed ALL remains poor, the treatment could be turned to the molecularly defined targeted drugs and stem cell transplantation. What is more, the progress in the detection technique for minimal residual disease and pharmacogenomics help to estimate the sensitivity of chemotherapy and judge the prognosis, so as to provide the reliable objective foundation for the individualized therapy.In this review, the present states of individualized therapy in childhood acute lymphoblastic leukemia is discussed and summarized.
Child ; Genomics ; Humans ; Neoplasm, Residual ; drug therapy ; Precision Medicine ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Humans ; Treatment Outcome ; Antibodies, Bispecific/adverse effects* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy* ; Antineoplastic Agents/adverse effects* ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Drug Therapy* ; Humans ; Lung Diseases, Interstitial* ; Megacolon, Toxic* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

OBJECTIVES: Rate of complete remission and long-term survival in adult acute lymphoblastic leukemia group has not been as satisfactory as that in childhood ALL. Recently introduction of induction chemotherapy of more intensive combination and various trials of postremission therapy are making improved results better looked forward to. And subtypes of ALL according to the degree of differentiation into T and B cells are identified by using immunologic markers hopefully to work out proper treatment for each subtype. METHODS: We analited results of treatment and differences of complete remission rate, remission duration and overall survival as to various immunologic markers and clinicopathologic characteristics in 33adult ALL patients. RESULTS: Eighty five percents of the 27cases that had VPDL chemotherapy achieved complete remission and both overall median survival and mediom duration of remission were 52weeks. No definite prognostic factors were detected influencing complete remission rate, remission duration and overall survival except that patients with serum albumin level higher than 4.0mg/dL showed highter complete remission rate. Although mature B-ALL showed the shortest overall median survival, degree of differenciation of B-cell and other immunologic markers did not influence on complete remission rate, remission duration or overall survival. CONCLUSION: Further studies are needed to delire the prognostic factors in adult ALL.
Adult ; B-Lymphocytes ; Biomarkers ; Drug Therapy ; Humans ; Induction Chemotherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Serum Albumin

PURPOSE: The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according to the vincristine administration in maintenance phase of ALL chemotherapy, we performed this study. METHODS: Eleven patients eligible under the criteria of Children's Cancer Study Group(CCG)-1882 and who had completed chemotherapy were enrolled in this study. The count of platelets before vincristine administration was compared with those of vincristine administration 1, 2 and 3 weeks after the early and last periods of maintenance phases. The platelet count before vincristine administration was defined as 100 percent and that after vincristine were compared. In addition, we tentatively defined an enhancing effect of vincristine as positive when the relative count was more than 120 percent. RESULTS: Platelet count did not differ according to the early and last periods of maintenance phase. Platelet count at first week after vincristine administration increased more significantly than that before vincristine in early and last periods. There was an enhancing effect in 10(90.9 percent) of 11 patients after 1 week vincristine administration both in the early and last periods of the maintenance phase. CONCLUSION: Vincristine, used in ALL maintenance phases as a low dose, increased platelet count 1 week after administration. The increased platelet count resumed to the previous level 2-3 weeks later. However, the thrombocytosis observed in the maintenance phase by vincristine was not high enough to induce thrombosis. In addition, vincristine is known to reduce the activity of platelets. Therefore, the risk of thrombosis in the maintenance phase of ALL chemotherapy would be low.
Blood Platelets* ; Drug Therapy* ; Humans ; Platelet Count* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Thrombocytosis ; Thrombosis ; Vincristine*

PURPOSE: The necessity of recombinant human erythropoietin (rhEpo) as a therapeutic agent in pediatric cancer patients has been challenged. Before clinical trials of the rhEpo, we evaluated the relationship of endogenous eythropoietin (Epo) level and hemoglobin (Hgb) in childhood acute lymphoblastic leukemia (ALL) and solid tumors. METHODS: Twenty eight children (20 ALL and 8 solid tumor) were involved in this study in Korea University Medical Center from January 1999 to June 1999. Epo and Hgb were measured simultaneously several times in the course of their diseases, and a simple regression analysis was performed to describe the Epo-Hgb relationship. RESULTS: 1) There was no inverse linear relationship between Log10Epo (LogEpo) and the variable Hgb of the control group (n=7). 2) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the induction and consolidation phase of the childhood ALL patients (n=14) (r=0.73, P<0.05). 3) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the reinduction phase of the childhood ALL patients (n=15) (r= 0.72, P<0.05). 4) There was a significant inverse linear relationship between LogEpo and the variable Hgb at the maintenance phase of the childhood ALL patients (n=19) (r= 0.74, P<0.05). 5) There was a significant inverse linear relationship between LogEpo and the variable Hgb during the chemotherapy of the childhood solid tumors patients (n=15) (r= 0.76, P<0.05). CONCLUSION: There was a significant inverse relationship between Epo and Hgb in pediatric cancer patients, suggesting that the negative feedback mechanism for endogenous production of Epo is intact.
Academic Medical Centers ; Anemia ; Child* ; Drug Therapy ; Erythropoietin* ; Humans ; Korea ; Pediatrics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*