ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Serum complement studies were carried out in five children with acute lymphocytic leukemia. During therapy with L-asparaginase, prednisone and vincristine, hypocomplementemia developed in all patients, and disappeared within 2 weeks after the discontinuation of L-asparaginase. Complement breakdown products were not present in plasma. The changes of serum complement levels paralleled those of plasma fibrinogen. These findings suggest that the hypocomplementemia observed in these patients may be related to impaired protein synthesis induced by L-asparaginase.L-Asparaginase, an enzyme isolated fromEscher-ichia coli. is an effective chemotherapeutic agent for the treatment of acute lymphocytic leukemia (ALL) in children.(1)Its antitumor activity is derived from depletion of the external source of L-asparagine, which is an essential amino acid for the metabolism of tumor cells. Although normal cells may produce ML-asparagine, cells actively synthesizing proteins may not be able to synthesize sufficient amounts of this amino acid to meet their requirements, resulting in decreased protein synthesis. Hence, there have been reports of hypoinsulinemia,1hypoalbuminemia,(1)hypofibrinogenemia,(4)as well as decreased levels of coagulation factors IX and XI.(4)The purpose of this paper is to report the occurrence of hypocomplementemia during induction therapy of ALL with L-asparaginase.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

A study was done to evaluate intramuscular versus intravenous administration of L-asparaginase in childhood leukemia. The results of this study demonstrate that the intramuscular method of administering L-asparaginase is as effective, but less toxic, than the intravenous method for children with advanced leukemia. The utilization of L-asparaginase in the initial induction of children with lymphoblastic and undifferentiated leukemia should be investigated. Its addition to the standard inducing agents may increase the percentage and ease of remission without significantly increasing toxicity.L-Asparaginase (L-asp) is an effective chemother-apeutic agent which produces remissions in 20–64% of patients with advanced acute lymphoblastic and undifferentiated leukemia. Its effectiveness in producing remissions in advanced disease suggests that it might be added to the drugs normally used in the initial treatment of acute lymphocytic (ALL) and undifferentiated (AUL) leukemia. For this purpose, the most effective but least toxic method of administering the agent should be used. This paper reports the results of a study undertaken by Children's Cancer Study Group on the effectiveness of two different routes of administration (intravenous versus intramuscular) of L-asparaginase as well as its usefulness as a maintenance drug.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Heterozygosity for β-thalassemia is usually characterized by hypochromia, microcytosis, mild anemia, an increased percentage of Hb A2, and normal or mildly increased Hb F. We have studied an unusual type of β-thalassemia with typical morphologic abnormalities but normal levels of Hb A2and Hb F, with diagnosis confirmed by globin synthesis studies. The results indicate that globin synthesis studies may be necessary when the cause of hypochromia and microcytosis cannot be clearly determined by hemoglobin quantitation and electrophoresis and other standard clinical tests.β-Thalassemia minor is usually characterized by hypochromia, microcytosis and an elevated percentage of hemoglobin A2(Hb A2). Fetal hemoglobin levels may also be slightly elevated in about half of affected persons.(1)β-Thalassemia minor with hypochromia, microcytosis, and normal levels of Hb A2and Hb F has occasionally been described, but documentation of the diagnosis has generally not been precise. We wish to report two heterozygotes of this type in whom the diagnosis has been confirmed by globin synthesis studies.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

An understanding of the pathology of central nervous system (CNS) leukemia has evolved slowly. Observations in the 19th century clearly established CNS leukemia as a disease involving the leptomeninges. Although infiltration of the leptomeninges by leukemic cells remains the principal CNS lesion in patients with this disease, other histopathologic changes have become evident with the development of antileukemic therapy. During the early years of chemotherapy, as patient survival increased, the effects of chronic meningeal leukemia, e.g., increased intracranial pressure, became prominent. Only recently, following effective control of CNS leukemia with chemotherapy and irradiation, did it become clear that current methods of treatment can produce neurotoxic effects. Two specific examples are leukoencephalopathy and mineralizing microangiopathy, both apparently induced by the effects of radiation on the microvasculature. Only through careful prospective studies can the consequences and actual incidence of these two lesions be determined. These results will permit sounder judgments of whether the risks of CNS radiotherapy outweigh the known benefits.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The cytocentrifuge provides a satisfactory method to distinguish malignant from nonmalignant CSF mononuclear elements in leukemic patients with pleocytosis. In patients who have had meningeal leukemia, our data support the concept that absence of all blasts be required to define remission. The finding of rare blasts by cytocentrifuge in patients with prior history of CNS leukemia, however, should be interpreted in light of the entire clinical and laboratory picture.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

At this time, methotrexate and CNS radiotherapy used together offer the best chance for prolonged remissions in children who develop overt CNS leukemia. Toxicity is a major problem. Unless a lower dose of radiation is used, the contribution of radiotherapy to neurotoxicity cannot be reduced. However, the toxicity of intrathecal methotrexate can be reduced by using Elliot's B as a diluent, combining methotrexate with hydrocortisone, and using a standard dose after the age of 3 years rather than a dose based on body surface area.Fortunately, the incidence of CNS leukemia has decreased over the years due to prophylactic CNS therapy. However, when a CNS relapse does occur, it carries a grave prognosis and is therefore still a significant problem necessitating continued research.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

At the present time, a successful regimen for the eradication of occult meningeal leukemia, following induction of a first complete remission in acute lymphoid and undifferentiated childhood leukemia, is the combination of cranial radiotherapy in a dose of 1800 rads in 10 fractions in 12–14 days with six doses of intrathecal methotrexate. This regimen, when given with prednisone and vincristine with or without L-asparaginase for induction and daily oral 6-mercapto-purine and weekly methotrexate for maintenance, can be expected to give a relapse rate for isolated meningeal leukemia of approximately 5% during the first 2 years of follow-up. A modification of this regimen utilizing craniospinal radiation with prior and concurrent intrathecal methotrexate is given for the treatment of overt meningeal leukemia at diagnosis or for an isolated first relapse with meningeal leukemia. Radiation technique and morbidity are discussed.

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID

ISSN:0192-8562    

出版商:OVID    

年代:1979

数据来源: OVID