Late marrow recurrences in childhood acute lymphoblastic leukaemia

Thirty children with acute lymphoblastic leukemia had a recurrence in the bone marrow after treatment was stopped electively. A second haematological remission was achieved in 27 (90%), and the median duration of remission was shortest (six months) in those relapsing within six months of stopping tr...

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Bibliographic Details
Published in:BMJ 1981-09, Vol.283 (6294), p.749-751
Main Authors: Chessells, J M, Breatnach, F
Format: Article
Language:English
Subjects:
Bone marrow
Bone Marrow - pathology
Bone Marrow Diseases - drug therapy
Bone Marrow Diseases - pathology
Central nervous system
Central Nervous System Diseases
Chemotherapy
Child
Childhood
Children
Clinical Research
Disease remission
Female
Humans
Leukemia
Leukemia, Lymphoid - drug therapy
Leukemia, Lymphoid - pathology
Lymphocytic leukemia
Male
Medical research
Prognosis
Recurrence
Relapse
Testicular Neoplasms - complications
Time Factors
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Summary:Thirty children with acute lymphoblastic leukemia had a recurrence in the bone marrow after treatment was stopped electively. A second haematological remission was achieved in 27 (90%), and the median duration of remission was shortest (six months) in those relapsing within six months of stopping treatment. Four of six children relapsing over one year after stopping treatment remained in second haematological remission. Leukaemic infiltration of the central nervous system developed in four patients remaining in marrow remission. It is concluded that conventional chemotherapy is unlikely to be effective in children with acute lymphoblastic leukaemia who relapse soon after stopping treatment, that "reprophylaxis" of the central nervous system probably with long-term intrathecal chemotherapy is essential, and that some patients relapsing after prolonged unmaintained remission may achieve long-term leukaemia-free survival.
ISSN:0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.283.6294.749