Entrar/Registro  
HOME SPANISH
 
Gaceta Médica de México
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Gaceta Médica de México >Year 2008, Issue 6


López-Hernández MA, Alvarado-Ibarra M, Jiménez-Alvarado RM, Diego-Flores JE, González-Avante CM
Adolescentes con leucemia aguda linfoblástica de novo: eficacia y seguridad de un protocolo pediátrico versus uno de adultos
Gac Med Mex 2008; 144 (6)

Language: Español
References: 18
Page: 485-490
PDF: 47.83 Kb.


Full text




ABSTRACT

Objective: To ascertain efficacy and safety of two chemotherapy regimens, one designed for adults and the other one for children, in adolescent patients with acute lymphoblastic leukemia (ALL). Methods: Between 2001-2006, we included patients aged 15-25, with de novo, Phi(-) ALL, without initial central nervous system (CNS) infiltration . Twenty patients received a chemotherapy regimen designed for children with high-risk ALL (LALIN) and twenty a regimen for adults (LALA). Both were intensive and included dexamethasone, daunorubicin, cyclophosphamide, vincristine, cytarabine, methotrexate and mercaptopurine as well as CNS prophylaxis. Elective suspension of chemotherapy occurred at two and three years respectively, in patients with continued complete remission. Results: Patients in both groups were comparable in age, sex, presence and size of hepatosplenomegaly, initial leukocytes and platelet counts. Predominant in both groups was L2 morphology and B-cell CD10(+) immunophenotype. Results for the LALIN/ LALA groups were: failures 2/0 (p=0.49); relapses 0/4 (p=0.05); therapy associated deaths 4/7 (p=0.48); and event free survival at 70 months follow-up was 70% and 40% (p=0.12). Conclusions: In patients aged 15-25, with de novo ALL, a chemotherapy regimen designed for children had significantly less relapses, than adult regimen. We saw no increase in toxicity in the LALIN versus the LALA group.


Key words: Lymphoblastic acute leukemia, chemotherapy, adolescents.


REFERENCIAS

  1. Pullen J, Schuster JJ, Borowitz M, Amylon M, Carroll AJ, Land V, et al. Significance of commonly used prognostic factors differs for children with T cell acute lymphocytic leukemia (ALL), as compared to those with B-precursor ALL. A Pediatric Oncology Group (POG Study). Leukemia 1999;13:1696-1707.

  2. Radich JP. Philadelphia chromosome-positive acute lymphocytic leukemia. Hematol Oncol Clin North Am 2001;15:21-36.

  3. Bleyer WA, Tejeda H, Murphy SB, Robison LL, Pollock BH, Severson RK, et al. National cancer clinical trials: Children have equal access; adolescents not. J Adolesc Health 1997;21(6):374-375.

  4. Larson RA, Dodge RK, Burns CP, Lee EJ, Stone RM, Sculman P, et al. A five-drug remission induction regimen with intensive consolidation for adults with acute lymphoblastic leukemia: Cancer and Leukemia Group B Study 8811. Blood 1995;85:2025-2037.

  5. Kantarjian HM, O’Brien S, Smith TL, Cortés J, Giles FJ, Beran M, et al. Results of treatment with hyper-CVAD, a dose intensive regimen, in adult acute lymphocytic leukemia. J Clin Oncol 2000;18:547-561.

  6. DeAngelo DJ. The treatment of adolescents and young adults with acute lymphoblastic leukemia. En: Berliner N, Lee SJ, Linenberger M, Vogelsang GB, editors. Hematology 2005. 1th edition. Washington, DC: The American Society of Hematology; 2005, pp. 123-130.

  7. Ruiz-Argüelles G, Apreza-Molina MG. Resultados del tratamiento de leucemias agudas en adolescentes. Rev Invest Clin 1997;49:271-275.

  8. Pui CH. Acute lymphoblastic leukemia. En: Beutler E, Lichtman MA, Coller BS, Kipps TJ, Seligsohn U, editors. Williams Hematology. 6th edition. New York: McGraw-Hill; 2001, pp. 1141-1161.

  9. Santana VM, Crist WM, Rivera GK, Look AT, Behm FG, Raimondi SC, et al. Presenting features and treatment outcome of adolescents with acute lymphoblastic leukemia. Leukemia 1990;4(2):87-90.

  10. Nachman JB. Adolescents with acute lymphoblastic leukemia: a new “age”. Rev Clin Exp Hematol 2003;7(3):261-269.

  11. Nachman JB. Clinical characteristics, biologic features and outcome for young adult patients with acute lymphoblastic leukemia. Br J Haematol 2005;130(2):166-173.

  12. Möricke A, Zimmermann M, Reiter A, Gadner H, Odenwald E, Harbott J, et al. Prognostic impact of age in children and adolescents with acute lymphoblastic leukemia: data from trails ALL-BFM 86, 90 and 95. Klin Padiatr 2005;217(6):310-320.

  13. Boissel N, Auclerc MF, Lheritier V, Perel Y, Thomas X, Leblanc T, et al. Should adolescents with acute lymophoblastic leukemia be treated as old children or young adults? Comparison of the French FRALLE-93 and LALA-94 trials. J Clin Oncol 2003;21:774-780.

  14. Schroder H, Kjeldstad M, Boesen AM, Nielsen OJ, Schmidt KG, Johnsen HE, et al. Acute lymphoblastic leukemia in Danish children and young people 10 to 19 years of age. Should young adults with acute lymphoblastic leukemia be treated in the same way as children? Ugeskr Laeger 2006;168(26-32):2554- 2558.

  15. Schroder H, Kjeldstad M, Boesen AM, Nielsen OJ, Schmidt KG, Johnsen HE, et al. Acute lymphoblastic leukemia in adolescents between 10 and 19 years of age in Denmark. Secundary publication. Dan Med Bull 2006;53(1):76-79.

  16. Hallböök H, Gustafsson G, Smedmyr B, Söderhäll S, Heyman M. Treatment outcome in young adults and children >10 years of age with acute lymphoblastic leukemia in Sweden: a comparison between a pediatric protocol and an adult protocol. Cancer 2006;107(7):1551-1561.

  17. Barry E, DeAngelo DJ, Neuberg D, Stevenson K, Loh ML, Asselin BL, et al. Favorable outcome for adolescents with acute lymphoblastic leukemia treated on Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium Protocols. J Clin Oncol 2007;25(7):813-819.

  18. Ramanujachar R, Richards S, Hann I, Webb D. Adolescents with acute lymphoblastic leukemia: emerging from the shadow of pediatric and adult treatment protocols. Pediatric Blood Cancer 2006;47(6):748-756.






>Journals >Gaceta Médica de México >Year 2008, Issue 6
 

· Journal Index 
· Links 






       
Copyright 2019