CNS-directed therapy in young children with T-lineage acute lymphoblastic leukemia: High-dose methotrexate versus cranial irradiation.

Abstract:

BACKGROUND:Prophylactic use of cranial radiation therapy (CRT) in young children with acute lymphoblastic leukemia (ALL) is associated with significant long-term morbidity. Therefore, current treatment protocols for pediatric B-precursor ALL have abandoned prophylactic CRT in favor of intrathecal chemotherapy, combined with either high-dose methotrexate infusions (HD-MTX) or intensive systemic chemotherapy. In contrast, prophylactic CRT continues to be used in children with T-lineage ALL (T-ALL), who historically have had an inferior prognosis. We conducted a retrospective cohort study to determine the effect on survival of substituting HD-MTX for CRT in young children with T-ALL, a group that faces a high risk of long-term sequelae from CRT. PROCEDURE:Twenty-six children, diagnosed with T-ALL between the ages of 1 and 5 years, were treated on the same high-risk leukemia protocol. Central nervous system (CNS) directed therapy consisted of either CRT (1,800 cGy) or HD-MTX (three doses of 8 g/m2), depending on the treatment era in which patients were diagnosed. RESULTS:Of the 24 patients who entered remission, 12 received CRT and 12 received HD-MTX. Five-year event-free survival (EFS) (+/-SE) was 92 +/- 8% in the HD-MTX group versus 75 +/- 13% in the CRT group (P=0.23). Five-year overall survival (OS) was 100% in the HD-MTX group versus 75 +/- 13% in the CRT group (P=0.07). There were no CNS recurrences in the HD-MTX group. One patient treated with CRT developed a brain tumor. CONCLUSIONS:The use of HD-MTX instead of CRT as CNS-directed therapy in very young children with T-ALL does not compromise survival, while avoiding the adverse long-term effects of cranial irradiation.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Nathan PC,Maze R,Spiegler B,Greenberg ML,Weitzman S,Hitzler JK

doi

10.1002/pbc.10392

keywords:

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

24-9

issue

1

eissn

1545-5009

issn

1545-5017

journal_volume

42

pub_type

杂志文章
  • Newborn Screening for Sickle Cell Disease in Liberia: A Pilot Study.

    abstract:BACKGROUND:In malaria-endemic countries in West Africa, sickle cell disease (SCD) contributes to childhood mortality. Historically, Liberia had regions wherein hemoglobin S and beta-thalassemia trait were mutually exclusive. Data on hemoglobinopathies in the Monrovia, the capital, are outdated and do not reflect urban ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.25875

    authors: Tubman VN,Marshall R,Jallah W,Guo D,Ma C,Ohene-Frempong K,London WB,Heeney MM

    更新日期:2016-04-01 00:00:00

  • New aspects of neuroblastoma treatment: ASPHO 2011 symposium review.

    abstract::Neuroblastoma is the most common extracranial solid tumor of childhood, and the outcomes for children with high-risk and relapsed disease remain poor. However, new international strategies for risk stratification and for treatment based on novel tumor targets and including immunotherapy are being employed in attempts ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.24116

    authors: Zage PE,Louis CU,Cohn SL

    更新日期:2012-07-01 00:00:00

  • Pharmacologic inhibition of epigenetic modification reveals targets of aberrant promoter methylation in Ewing sarcoma.

    abstract:BACKGROUND:Ewing sarcoma (ES), a highly aggressive tumor of children and young adults, is characterized most commonly by an 11;22 chromosomal translocation that fuses EWSR1 located at 22q12 with FLI1, coding for a member of the ETS family of transcription factors. Although genetic changes in ES have been extensively re...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/pbc.24526

    authors: Nestheide S,Bridge JA,Barnes M,Frayer R,Sumegi J

    更新日期:2013-09-01 00:00:00

  • Reduced-toxicity alternate-donor stem cell transplantation with posttransplant cyclophosphamide for primary immunodeficiency disorders.

    abstract::We describe here the outcomes of reduced-toxicity alternate-donor stem cell transplant (SCT) with posttransplant cyclophosphamide (PTCy) for primary immunodeficiency disorders (PIDs) in eight children (haploidentical-seven and matched unrelated donor-one). The conditioning was with serotherapy (alemtuzumab-3/rabbit-an...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.26783

    authors: Rastogi N,Katewa S,Thakkar D,Kohli S,Nivargi S,Yadav SP

    更新日期:2018-01-01 00:00:00

  • Long-term results of the AIEOP LNH-97 protocol for childhood lymphoblastic lymphoma.

    abstract:BACKGROUND:Treatment intensification was considered a suitable strategy to increase the cure rate of lymphoblastic lymphoma (LBL) in children. PROCEDURE:The AIEOP LNH-97 trial was run between 1997 and 2007 for newly diagnosed LBL in patients aged less than 18 years. Treatment schedule was based on the previous, LSA2-L...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章

    doi:10.1002/pbc.25469

    authors: Pillon M,Aricò M,Mussolin L,Carraro E,Conter V,Sala A,Buffardi S,Garaventa A,D'Angelo P,Lo Nigro L,Santoro N,Piglione M,Lombardi A,Porta F,Cesaro S,Moleti ML,Casale F,Mura R,d'Amore ES,Basso G,Rosolen A

    更新日期:2015-08-01 00:00:00

  • Incidence of acute kidney injury among pediatric hematology/oncology patients receiving vancomycin in combination with piperacillin/tazobactam or cefepime.

    abstract::There is mounting evidence that combination of antibiotic therapy with vancomycin and piperacillin/tazobactam (pip/tazo) is associated with acute kidney injury (AKI). To determine whether vancomycin plus pip/tazo is associated with higher rates of AKI compared to vancomycin plus cefepime among pediatric hematology/onc...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章

    doi:10.1002/pbc.27750

    authors: Quach HT,Esbenshade AJ,Zhao Z,Banerjee R

    更新日期:2019-07-01 00:00:00

  • Patient and health service factors associated with delays in cancer treatment for children without social security in Mexico.

    abstract:BACKGROUND:The objective was to investigate factors associated with patient-related timing (PRT) to seek healthcare and health service-related timing (HSRT) to diagnose cancer and provide treatment to children without social security in Mexico. PROCEDURE:A cross-sectional survey was conducted in 13 Ministry of Health ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.28331

    authors: Zapata-Tarrés M,González-Domínguez E,Doubova SV,Menendez-Auld N,Cruz-Medina CS,Gonzalez-Ramella RO,Vega-Vega L,Guevara-Espejel C,Juárez-Villegas L,Pérez-Cuevas R

    更新日期:2020-09-01 00:00:00

  • Treatment of intestinal and hepatic mucormycosis in an immunocompromized child.

    abstract::During ALL chemotherapy, a 4-year-old patient presented with febrile neutropenia and abdominal pain. Ultrasound examinations were repeatedly normal. Computerized tomography on day 7 demonstrated appendicitis and multiple hepatic foci identified as mucormycosis (Absidia corymbifera). Successful outcome was achieved by ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21918

    authors: Lüer S,Berger S,Diepold M,Duppenthaler A,von Gunten M,Mühlethaler K,Wolf R,Aebi C

    更新日期:2009-07-01 00:00:00

  • Evaluating physical function in an adolescent bone tumor population.

    abstract:BACKGROUND:Survival rates for patients with bone tumors have increased dramatically over the past few decades. Unfortunately, many patients face functional limitations resulting from disease management, but there is little evidence regarding physical functioning in adolescents with bone tumors. This lack is largely due...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.20383

    authors: Pakulis PJ,Young NL,Davis AM

    更新日期:2005-10-15 00:00:00

  • Risk prediction of fever in neutropenia in children with cancer: a step towards individually tailored supportive therapy?

    abstract:BACKGROUND:Fever in severe chemotherapy-induced neutropenia (FN) is the most frequent manifestation of a potentially lethal complication of current intensive chemotherapy regimens. This study aimed at establishing models predicting the risk of FN, and of FN with bacteremia, in pediatric cancer patients. METHODS:In a s...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21726

    authors: Wicki S,Keisker A,Aebi C,Leibundgut K,Hirt A,Ammann RA

    更新日期:2008-12-01 00:00:00

  • Dose response and local control using radiotherapy in non-metastatic Ewing sarcoma.

    abstract:BACKGROUND:To determine prognostic factors for local control in the radiotherapeutic management of non-metastatic Ewing sarcoma. PROCEDURE:Forty patients with localized Ewing sarcoma (ES) were treated with primary site RT at one institution. Median RT dose was 55.8 Gy (range, 25.5-76 Gy). Chemotherapy was given to 34 ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.20904

    authors: Paulino AC,Nguyen TX,Mai WY,Teh BS,Wen BC

    更新日期:2007-08-01 00:00:00

  • Imaging guidelines for children with Ewing sarcoma and osteosarcoma: a report from the Children's Oncology Group Bone Tumor Committee.

    abstract::The Children's Oncology Group (COG) is a multi-institutional cooperative group dedicated to childhood cancer research that has helped to increase the survival of children with cancer through clinical trials. These clinical trials include a standardized regimen of imaging examinations performed prior to, during, and fo...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,实务指引

    doi:10.1002/pbc.21596

    authors: Meyer JS,Nadel HR,Marina N,Womer RB,Brown KL,Eary JF,Gorlick R,Grier HE,Randall RL,Lawlor ER,Lessnick SL,Schomberg PJ,Kailo MD

    更新日期:2008-08-01 00:00:00

  • Features and outcome of neonatal leukemia in Japan: experience of the Japan infant leukemia study group.

    abstract:BACKGROUND:Neonatal leukemia characterized by early stem cell origin and extramedullary infiltration in the first 4 weeks of life is rare. We analyzed the features and outcome of neonatal leukemia in Japan to establish an appropriate treatment strategy for this rare disorder. PROCEDURE:Patients with infant leukemia re...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章

    doi:10.1002/pbc.20599

    authors: Ishii E,Oda M,Kinugawa N,Oda T,Takimoto T,Suzuki N,Kosaka Y,Ohara A,Ogawa A,Ishii M,Sakata N,Okamura T,Koike K,Kojima S,Horibe K,Mizutani S

    更新日期:2006-09-01 00:00:00

  • Multimodality treatment of osteosarcoma: radiation in a high-risk cohort.

    abstract:PURPOSE:Chemotherapy during radiation and/or bone-seeking radioisotope therapy (153-samarium; 1 mCi/kg) during radiation may improve osteosarcoma cancer control. PATIENTS AND METHODS:We analyzed our preliminary radiation experience in high-risk, metastatic, and/or recurrent patients during a consecutive period of 20 m...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21451

    authors: Mahajan A,Woo SY,Kornguth DG,Hughes D,Huh W,Chang EL,Herzog CE,Pelloski CE,Anderson P

    更新日期:2008-05-01 00:00:00

  • Improving outcomes for high-risk ALL: translating new discoveries into clinical care.

    abstract::High-risk (HR) acute lymphoblastic leukemia (ALL) remains one of the greatest challenges in pediatric oncology. Relapsed ALL is a leading cause of death in young people, and further improvements in outcome will required the development of therapeutic approaches directed against rational therapeutic targets, as escalat...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.22996

    authors: Hunger SP,Raetz EA,Loh ML,Mullighan CG

    更新日期:2011-06-01 00:00:00

  • Treatment and outcome of patients with thoracic tumors of the Ewing sarcoma family: A report from the Cooperative Weichteilsarkom Studiengruppe CWS-81, -86, -91, -96, and -2002P trials.

    abstract:BACKGROUND:Ewing tumors are the most frequent malignant tumors of the chest wall in children and young adults. Surgical management of these tumors can be challenging. Optimal local control remains controversial. The aim of this study was to analyze treatment, outcome, and surgical procedures in patients with thoracic t...

    journal_title:Pediatric blood & cancer

    pub_type: 更正并重新发布的文章,杂志文章

    doi:10.1002/pbc.27884

    authors: Seitz G,Urla C,Sparber-Sauer M,Schuck A,Vokuhl C,Blank B,Klingebiel T,Kazanowska B,Fuchs J,Koscielniak E

    更新日期:2019-08-01 00:00:00

  • Soft tissue sarcoma across the age spectrum: a population-based study from the Surveillance Epidemiology and End Results database.

    abstract:BACKGROUND:Soft tissue sarcomas (STS) are a heterogeneous group of mesenchymal malignancies that occur throughout the lifespan. The impact of age on disease features and outcome is unclear. METHODS:We analyzed the clinical features and outcome of all STS cases registered between 1973 and 2006 in the SEER database. RE...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.23252

    authors: Ferrari A,Sultan I,Huang TT,Rodriguez-Galindo C,Shehadeh A,Meazza C,Ness KK,Casanova M,Spunt SL

    更新日期:2011-12-01 00:00:00

  • Retinoic acid therapy in "degenerative-like" neuro-langerhans cell histiocytosis: a prospective pilot study.

    abstract:BACKGROUND:Degenerative-like neuro-Langerhans cell histiocytosis (DN-LCH) is a rare complication of LCH marked by progressive cerebellar ataxia. No treatment has so far been shown to slow this progression. PROCEDURE:All-trans retinoic acid (ATRA) was administered orally at a dose of 45 mg/m(2) daily for 6 weeks and th...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/pbc.20040

    authors: Idbaih A,Donadieu J,Barthez MA,Geissmann F,Bertrand Y,Hermine O,Brugières L,Genereau T,Thomas C,Hoang-Xuan K

    更新日期:2004-07-01 00:00:00

  • Initial liver transplantation for unresectable hepatoblastoma after chemotherapy.

    abstract:BACKGROUND:SIOPEL protocols have recommended liver transplantation for unresectable hepatoblastoma (HBL) after chemotherapy in absence of visible extrahepatic disease. METHODS:This retrospective single center study includes 13 children treated following SIOPEL 3 or 4 protocols who underwent orthotopic liver transplant...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.23301

    authors: Héry G,Franchi-Abella S,Habes D,Brugières L,Martelli H,Fabre M,Pariente D,Gauthier F,Jacquemin E,Branchereau S

    更新日期:2011-12-15 00:00:00

  • Incidence of Langerhans cell histiocytosis in children: a population-based study.

    abstract:BACKGROUND:Langerhans cell histiocytosis is a rare disease of unknown etiology. We wanted to assess the population-based incidence of LCH in a well-defined cohort of children. METHODS:We identified all children <15-years old treated with LCH during the 10 years period 1992-2001 at the Department of Pediatrics, Karolin...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21504

    authors: Stålemark H,Laurencikas E,Karis J,Gavhed D,Fadeel B,Henter JI

    更新日期:2008-07-01 00:00:00

  • Children with sickle cell disease migrating to the United States from sub-Saharan Africa.

    abstract::Sickle cell disease (SCD) is an inherited red blood cell disorder that occurs worldwide and results in significant morbidity and mortality. In addition to affected children who are born in the US, an increasing number of children with SCD are migrating to the US with their families or through international adoption. C...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.27000

    authors: Thornburg CD,Ware RE

    更新日期:2018-06-01 00:00:00

  • Homestead together: Pediatric palliative care telehealth support for rural children with cancer during home-based end-of-life care.

    abstract:BACKGROUND:Children with terminal cancer and their families describe a preference for home-based end-of-life care. Inadequate support outside of the hospital is a limiting factor in home location feasibility, particularly in rural regions lacking pediatric-trained hospice providers. METHODS:The purpose of this longitu...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.28921

    authors: Weaver MS,Shostrom VK,Neumann ML,Robinson JE,Hinds PS

    更新日期:2021-02-01 00:00:00

  • Hypofractionated re-irradiation to the brainstem in children with recurrent brain tumors.

    abstract::To characterize radiation necrosis following hypofractionated brainstem re-irradiation in pediatric patients, we reviewed 23 cases with 28 tumors invading or abutting brainstem and treated with hypofractionated re-irradiation from 2004 to 2014. Re-irradiation delivered total doses of 16-30 Gy in two to five fractions....

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.26341

    authors: Waxweiler TV,Amini A,Vinogradskiy Y,Yeh N,Foreman NK,Hankinson TC,Liu AK

    更新日期:2017-05-01 00:00:00

  • Long-term outcomes of Group D eyes in bilateral retinoblastoma patients treated with chemoreduction and low-dose IMRT salvage.

    abstract:BACKGROUND:To evaluate outcomes of Group D eyes of bilateral retinoblastoma patients treated with primary chemoreduction and external beam radiation as salvage. PROCEDURE:Retrospective chart review of patients diagnosed with bilateral retinoblastoma and designated Group D in at least one eye from January 1, 2000 to De...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.24303

    authors: Berry JL,Jubran R,Kim JW,Wong K,Bababeygy SR,Almarzouki H,Lee TC,Murphree AL

    更新日期:2013-04-01 00:00:00

  • Familial small cell carcinoma of the ovary.

    abstract::Ovarian tumors have a low incidence in childhood, accounting for 1% of malignancies within the ages of 0-17 years. Small cell carcinoma of the ovary is a rare histology and historically has a poor prognosis. We report a case of an 11-year-old female diagnosed with small cell carcinoma of the ovary and hypercalcemia (S...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.22184

    authors: Martinez-Borges AR,Petty JK,Hurt G,Stribling JT,Press JZ,Castellino SM

    更新日期:2009-12-15 00:00:00

  • Hepatoblastoma in patients with molecularly proven familial adenomatous polyposis: Clinical characteristics and rationale for surveillance screening.

    abstract::Familial adenomatous polyposis (FAP) due to APC mutation is associated with an increased risk of hepatoblastoma. All cases of hepatoblastoma in patients with FAP reported in the literature were reviewed. One hundred and nine patients were identified. Thirty-five patients (of 49 with data) were diagnosed with hepatobla...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章,评审

    doi:10.1002/pbc.27103

    authors: Trobaugh-Lotrario AD,López-Terrada D,Li P,Feusner JH

    更新日期:2018-08-01 00:00:00

  • A Child With Dyserythropoietic Anemia and Megakaryocyte Dysplasia Due to a Novel 5'UTR GATA1s Splice Mutation.

    abstract::We describe a child with dyserythropoietic anemia, thrombocytosis, functional platelet defect, and megakaryocyte dysplasia. We show that (i) this constellation of hematopoietic abnormalities was due to a germline mutation within the 5' untranslated region (5'UTR) of globin transcription factor 1 (GATA1); (ii) the muta...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.25871

    authors: Zucker J,Temm C,Czader M,Nalepa G

    更新日期:2016-05-01 00:00:00

  • Early cardiac outcomes following contemporary treatment for childhood acute myeloid leukemia: a North American perspective.

    abstract:BACKGROUND:Anthracycline agents are used for treatment of acute myeloid leukemia (AML) but may cause late-onset cardiomyopathy. Current frontline therapy for AML in North America, as reflected in the approach of the Children's Oncology Group (COG) and other pediatric consortia, is adapted from the anthracyline-intensiv...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/pbc.24498

    authors: Orgel E,Zung L,Ji L,Finklestein J,Feusner J,Freyer DR

    更新日期:2013-09-01 00:00:00

  • Young siblings of children with cancer deserve care and a personalized approach.

    abstract::The youngest siblings may be both emotionally vulnerable and often neglected members of the family of a childhood cancer patient. The prompt identification of signs of distress in these subjects allows trained caregivers to intervene with personalized, age-appropriate, attention, and care. A narrative approach, based ...

    journal_title:Pediatric blood & cancer

    pub_type: 杂志文章

    doi:10.1002/pbc.21056

    authors: Massimo LM,Wiley TJ

    更新日期:2008-03-01 00:00:00

  • Factors affecting response to everolimus therapy for subependymal giant cell astrocytomas associated with tuberous sclerosis.

    abstract:BACKGROUND:The aim of the study was to investigate factors affecting response to everolimus, a mammalian-target-of-rapamycin (mTOR) inhibitor, of subependymal giant cell astrocytomas (SEGA) in patients with tuberous sclerosis complex (TSC). METHODS:The study group consisted of 15 children with a diagnosis of TSC-relat...

    journal_title:Pediatric blood & cancer

    pub_type: 临床试验,杂志文章

    doi:10.1002/pbc.25368

    authors: Trelinska J,Dachowska I,Kotulska K,Baranska D,Fendler W,Jozwiak S,Mlynarski W

    更新日期:2015-04-01 00:00:00