Analysis of treatment in childhood leukaemia. V. Advantage of reduced chemotherapy during and immediately after cranial irradiation

MacLennan, I. C. M.; Peto, Julian; Kay, H. E. M.

doi:10.1038/bjc.1977.240

Cited by 15 publications

(2 citation statements)

References 6 publications

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“…Eiser (1978) found no adverse effect from cranial irradiation administered 6 months or more after diagnosis, but did fmd an effect from administration within 2 months. This finding has not been subsequently pursued, but several other investigators have pointed to the possible importance of coincident administration of cranial irradiation and methotrexate (Price & Jamieson, 1975;MacLennan, Peto & Kay, 1977;Goff et al, 1980;Paolucci & Rosito, 1983;Lansky, Gairns, Lansky, Gairns, Stephenson & Garin, 1984).…”

Section: Discussionmentioning

confidence: 99%

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

Cousens

Waters

Said

et al. 1988

Child Psychology Psychiatry

172

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Central nervous system (CNS) prophylaxis involving cranial irradiation has frequently been found to result in cognitive deficits in survivors of childhood acute lymphoblastic leukaemia. The existence of this effect is still controversial, however, as is the question of factors that might affect its severity. The literature is surveyed and a meta-analysis undertaken on 30 IQ comparisons, which shows a substantial average decrement in irradiated subjects. The effect is larger when radiation is administered at a younger age and appears to be progressive. The effect may comprise two elements, one common to young cancer patients and one specific to CNS prophylaxis.

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Section: Discussionmentioning

confidence: 99%

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

Cousens

Waters

Said

et al. 1988

Child Psychology Psychiatry

172

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“…The patients were treated according to the following Medical Research Council trials [16];UKALLI Cases 1-5,UKALL I1 Cases 6-21,UKALL 111 Cases 22-25. Induction treatment with prednisolone, vincristine, and L-asparaginase was followed by main- [ ] Banding inadequate for full analysis.…”

Section: Methodsmentioning

confidence: 99%

Bone marrow chromosomes in acute lymphoblastic leukaemia: A long‐term study

Secker-Walker

Swansbury

Lawler

et al. 1979

Med. Pediatr. Oncol.

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The bone marrow chromosomes of 25 children with acute lymphoblastic leukaemia (ALL) were examined at diagnosis before treatment, during remission, and in 12 cases, also during relapse. Follow-up was for at least six years. At diagnosis, 17 patients had a major population of chromosomally abnormal cells and of these 11 had identifiable clones. The commonest abnormality was hyperdiploidy. Eight patients had predominantly normal cells, but four of these had a minor abnormal clone. In remission, some samples were completely normal but, when pooled, remission samples had a minor population of chromosomally aberrant cells which were rarely clonal. The incidence of structural abnormalities was the same in patients who ultimately relapsed and those who remained in first remission at the end of the study, but the presence of hyperdiploid cells and/or clones in remission was more frequently associated with subsequent relapse. Relapse patterns were of two kinds: in three patients there was a return of the chromosomal abnormalities seen at diagnosis; in six others, chromosomal features in relapse were distinct from those at diagnosis. It is suggested that relapse associated with distinct chromosomal features may represent malignant transformation of a previously unaffected cell line. While chromosomal abnormalities seen prior to treatment can be related to the leukaemic event alone, abnormalities seen in remission and in relapse may result partly from drug and X-ray treatment. The relative importance of treatment and other factors to chromosomal change in ALL is discussed.

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Combination chemotherapy for bone marrow relapse in childhood lymphoblastic leukaemia (all)

Chessells¹,

Cornbleet²

1979

Med. Pediatr. Oncol.

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Thirty-four children with acute lymphoblastic leukaemia (ALL) in relapse or resistant to initial induction received combination chemotherapy with prednisolone, vincristine, l-asparaginase, and daunorubicin. L-asparaginase was given subcutaneously on alternate days for four weeks and was well tolerated. A complete remission was achieved in 96% of children in relapse and in five out of six children resistant to induction. Remission was achieved without hospitalisation in over 60% of patients. The median duration of subsequent remission was only 13 weeks, but six out of eight children receiving a second course of the drug combination achieved a further remission. We conclude that prolonged l-asparaginase therapy in combination with an anthracycline might well be used in initial or consolidation therapy for childhood ALL.

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Analysis of treatment in childhood leukaemia. V. Advantage of reduced chemotherapy during and immediately after cranial irradiation

Cited by 15 publications

References 6 publications

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

Bone marrow chromosomes in acute lymphoblastic leukaemia: A long‐term study

Combination chemotherapy for bone marrow relapse in childhood lymphoblastic leukaemia (all)

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