Adjuvant low dose radiation in childhood T cell leukaemia/lymphoma (report from the United Kingdom Childrens' Cancer Study Group--UKCCSG)

Abstract

, 82 children with T leukaemia/lymphoma entered a randomised trial of combination chemotherapy and radiotherapy. Twenty-five were designated T lymphoma and 57 T leukaemia, 28 having > 100 x 1091 1 blasts in peripheral blood at diagnosis. Twenty-seven patients with mediastinal primaries who were treated on the companion non-Hodgkin lymphoma (NHL) trial were comparable in all respects to the T lymphoma patients and the results of treatment were therefore combined and analysed together. Overall 4-year survival (48-53%) and failure-free survival (FFS) (37-40%) were similar in all groups except the 28 with T leukaemia and WCC>100 x 10 1-1 (20% and 13%). There was a significant advantage in FFS for patients randomised to receive low dose mediastinal radiation, and this was most marked in patients with T lymphoma (66% vs 18%, P=0.006).

Adjuvant low dose radiation in childhood non-Hodgkin's lymphoma (report from the United Kingdom Childrens' Cancer Study Group--UKCCSG)

“…Half of the patients required a 15% or greater reduction in chemotherapy at some stage in their programme, and both survival and FFS were substantially better in that group when compared to those not reported to require dose modifications. The same was true for patients on the more intensive T cell protocol (Mott et al, 1984) and the difference for both trials combined is highly significant. The types of toxicity encountered and their relationship to prognosis will be the subject of a separate report.…”

“…These patients continued to suffer relapse throughout the two year period of chemotherapy and subsequently on both the NHL and the intensified T cell protocols. The implications for future treatment of T cell disease are discussed in the companion report (Mott et al, 1984).…”

“…(Mott et al, 1984). Forty-eight other patients registered on the study were excluded from the trial for the reasons indicated in Table II.…”

Growth following single fraction and fractionated total body irradiation for bone marrow transplantation

“…Patients with ALL had been previously treated using protocols established by the Medical Research Council [5], the United Kingdom Children's Cancer Study Group [12] or by the Hospital for Sick Children [4], Intrathecal methotrexate and/or cytosine was used in all patients to prevent leukaemic meningeal infiltration. Patients with acute myeloid lenkaemia were treated with either daunorubicin, cytosine arabinoside and thioguanine alone (Medical Research Council, acute myeloid leukaemia VIII) or with two courses of this prior to one course of M-AMSA, azacytidine and etoposide VP16.…”

Growth hormone treatment of growth failure secondary to total body irradiation and bone marrow transplantation.

“…tion, case 2 had compensated hypothyroidism Adrenal function was considered normal in all identified by persistently raised concentrations patients except two (cases 7 and 13), who subsequently received hydrocortisone replacement all patients increased their growth velocity, expressed as height velocity SD score (SD), The , I , I , I I I I I response of subischial leg length to growth hor-i7 8 9 10 11 12 13 14 15 16 17 18 mone treatment was also not significant: in the Age (years) first year mean subischial leg length SD score iischial leg length response to treatment with growth was -0-63 (0-65), in the second year -0-58 iment of adult stature. Epiphyseal maturation was oneyear (0 70), and in the third year -0-8 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). An tart of treatment.…”