Effective Prevention of Central Nervous System Leukemia with Intrathecal Methotrexate and Intrathecal Methotrexate, Cytosine Arabinoside, and Hydrocortisone in Childhood Acute Lymphocytic Leukemia

Aur, Rhomes J. A.; Hanna, Merit; Sabbah, Rajeh; Sackey, Kwesi; Atwood, J.

doi:10.1007/978-3-642-74643-7_91

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…It can be used either alone or in combination with other IT chemotherapies such as Methotrexate to treat or prevent central nervous system (CNS) involvement by leukemic cells. 3–5…”

Section: Introductionmentioning

confidence: 99%

“…It can be used either alone or in combination with other IT chemotherapies such as Methotrexate to treat or prevent central nervous system (CNS) involvement by leukemic cells. [3][4][5] Toxicities following administration of IT Cytarabine have been described in the literature. [4][5][6][7][8][9][10] Neurotoxicity is the most commonly described side effect.…”

Section: Introductionmentioning

confidence: 99%

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Safety of inadvertent administration of overdose of intrathecal Cytarabine in a pediatric patient

Omar

Amayiri

Madanat

2014

J Oncol Pharm Pract

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“…It can be used either alone or in combination with other IT chemotherapies such as Methotrexate to treat or prevent central nervous system (CNS) involvement by leukemic cells. 3–5…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety of inadvertent administration of overdose of intrathecal Cytarabine in a pediatric patient

Omar

Amayiri

Madanat

2014

J Oncol Pharm Pract

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Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis.

Viana

Murao

Ramos

et al. 1994

Archives of Disease in Childhood

154

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(11-58 months), the estimated probability of relapse free survival was 41% (7%) for the whole group. After adjustment in the Cox's multivariate model, malnutrition was the most significant adverse factor affecting duration of complete remission. Age above 8 years and high peripheral white celi count were also significant adverse factors. Among the nutritional indices, the height for age and weight for age z scores were both significant, whether the cut off points of z-2 or z=-1*28 were chosen to define malnutrition. A strong statistical association between the two indices was found; the contribution of height for age z score to the prediction of relapse free survival was more significant. Children with height for age z score <-2 had a relapse risk of 8*2 (95Gb confidence interval 3*1 to 21-9) relative to children with z score > -2. The results of this study suggest that socioeconomic and nutritional factors should be considered in the prognostic evaluation of children with leukaemia in developing countries. (Arch Dis Child 1994; 71: 304-3 10)

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Importance of effective central nervous system therapy in isolated bone marrow relapse of childhood acute lymphoblastic leukemia. BFM (Berlin- Frankfurt-Munster) Relapse Study Group

Bührer

Hartmann

Fengler

et al. 1994

Blood

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Presymptomatic central nervous system (CNS) treatment in children with a late isolated first bone marrow (BM) relapse of acute lymphoblastic leukemia (ALL) was based on intermediate-dose systemic and intrathecal (IT) methotrexate (MTX) in the multicenter trial, ALL-REZ BFM 85. Because this was associated with an excess of overt second CNS relapses, cranial radiotherapy (cRT) plus prolonged triple IT therapy with MTX, cytarabine, and prednisone was instituted during the course of the subsequent trial, ALL-REZ BFM 87. Results of children with or without cRT, but otherwise identical chemotherapy, are presented here. Between April 1985 and March 1990, 93 children with their first late isolated BM relapse of ALL were entered on protocols ALL-REZ BFM 85M and ALL-REZ BFM 87. An intensive 6-month phase of multiagent chemotherapy that included 8 courses of systemic MTX (1 g/m2) plus IT MTX was followed by 2 years of conventional maintenance therapy with daily 6-thioguanine and biweekly MTX. Children with bone marrow transplantation excluded, 73 were in complete remission at the end of intensive polychemotherapy, 40 of whom received fractionated cRT plus triple IT therapy during the following 6 months; 11 did not receive cRT but prolonged triple IT; 22 received neither cRT nor prolonged triple IT. Except for a higher percentage of children who had received cRT in front-line protocols (29 of 33 v 20 of 40), the patient groups without or with salvage cRT were comparable. Of 33 children without salvage cRT, 26 relapsed, compared with 21 of 40 who had received cRT (P < .05). The difference was solely attributable to second relapses with CNS involvement (10 of 33 v 1 of 40; P < .01). Estimated 6-year event- free survival rates were .18 for children without cRT and .46 for children with cRT (P < .01). In patients without cRT, no impact of prolonged IT therapy could be shown. The data suggest that second CNS prophylaxis with cRT and prolonged triple IT therapy in children with late isolated BM relapse of ALL is effective in preventing CNS relapses, in reducing the overall relapse rate, and in increasing the overall survival rate.

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Effective Prevention of Central Nervous System Leukemia with Intrathecal Methotrexate and Intrathecal Methotrexate, Cytosine Arabinoside, and Hydrocortisone in Childhood Acute Lymphocytic Leukemia

Cited by 3 publications

References 6 publications

Safety of inadvertent administration of overdose of intrathecal Cytarabine in a pediatric patient

Safety of inadvertent administration of overdose of intrathecal Cytarabine in a pediatric patient

Malnutrition as a prognostic factor in lymphoblastic leukaemia: a multivariate analysis.

Importance of effective central nervous system therapy in isolated bone marrow relapse of childhood acute lymphoblastic leukemia. BFM (Berlin- Frankfurt-Munster) Relapse Study Group

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