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Triple intrathecal therapy without cranial irradiation for central nervous system preventive therapy in childhood acute lymphoblastic leukemia
Author(s) -
Lin WeiYing,
Liu HsiChe,
Yeh TingChi,
Wang LinYen,
Liang DerCherng
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21212
Subject(s) - medicine , cytarabine , context (archaeology) , cohort , pediatrics , leukemia , pediatric cancer , radiation therapy , cancer , paleontology , biology
Background To evaluate the treatment results of central nervous system preventive therapy (CNSP) with triple intrathecal therapy (TIT) alone in children with acute lymphoblastic leukemia (ALL). Methods We retrospectively studied a cohort of 59 patients with median follow‐up time 50.6 months (range: 27–80 months) at a single institution in Taiwan. Patients with ALL were classified in risk groups at diagnosis. TPOG‐ALL‐93 protocols and TPOG‐ALL‐2002 protocols were used. Both protocols were for multicenter studies in Taiwan and contained protocols for standard‐risk (SR), high‐risk (HR), and very‐high‐risk (VHR) patients. In this study, we used TIT alone for CNSP. In all ALL patients, methotrexate, hydrocortisone, and cytarabine were given at age‐dependent doses. Results As of October 2006, patients had a 3‐year event‐free survival and an overall survival 89.4 ± 4.1% (S.E.) and 93.1 ± 3.3%, respectively. Under TIT no patients had complications such as seizure, encephalitis, or infection, and no morbidities like those caused by cranial irradiation. In this study, we used TIT alone for CNSP and had no CNS relapse. Conclusions In the context of effective systemic therapy, TIT alone appears to be effective CNSP for most patients with ALL. Pediatr Blood Cancer 2008;50:523–527. © 2007 Wiley‐Liss, Inc.