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Treatment of isolated testicular recurrence of acute lymphoblastic leukemia without radiotherapy
Author(s) -
van den Berg Henk,
Langeveld Nelia E.,
Veenhof Cees H. N.,
Behrendt Henk
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970601)79:11<2257::aid-cncr26>3.0.co;2-u
Subject(s) - medicine , lymphoblastic leukemia , radiation therapy , oncology , leukemia , pediatrics
Abstract BACKGROUND The isolated recurrence of testicular leukemia in boys with acute lymphoblastic leukemia (ALL) is considered to be an ominous sign, heralding generalized recurrence. In general, treatment is comprised of systemic retreatment and local radiotherapy to one or both affected testes. METHODS In this study, the authors report five boys with a late isolated testicular recurrence of ALL during sustained bone marrow remission, in whom radiotherapy had been omitted. High dose methotrexate was included in the treatment regimen. RESULTS No further recurrences occurred after cessation of therapy. The follow‐up period ranged from 1‐15 years (median, 8 years). CONCLUSIONS These cases show that there is a subpopulation of boys with recurrence of testicular leukemia who can be treated without radiotherapy. Therefore, the authors propose a treatment regimen for boys with late isolated recurrence of testicular leukemia in which conventional reinduction maintenance treatment is given in combination with high dose methotrexate. Radiotherapy should be withheld until subsequent testicular recurrence occurs. Cancer 1997; 79:2257‐62. © 1997 American Cancer Society.