Immunogenicity of trivalent influenza vaccine in children with acute lymphoblastic leukemia during maintenance therapy

2010 ◽  
Vol 54 (5) ◽  
pp. 716-720 ◽  
Author(s):  
Elham Shahgholi ◽  
Mohammad Ali Ehsani ◽  
Payman Salamati ◽  
Alipasha Maysamie ◽  
Kambiz Sotoudeh ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Influenza Vaccine ◽  
Maintenance Therapy ◽  
Lymphoblastic Leukemia ◽  
Trivalent Influenza Vaccine

Immunogenicity of subunit trivalent influenza vaccine in children with acute lymphoblastic leukemia

1998 ◽  
Vol 17 (2) ◽  
pp. 125-129 ◽  
Author(s):  
LIDIA B. BRYDAK ◽  
ROMA ROKICKA-MILEWSKA ◽  
MAGDALENA MACHAŁA ◽  
TERESA JACKOWSKA ◽  
BARBARA SIKORSKA-FIC
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Influenza Vaccine ◽  
Lymphoblastic Leukemia ◽  
Trivalent Influenza Vaccine

scholarly journals Salivary and serum concentrations of selected pro- and antiinflammatory cytokines in relation to oral lesions among children undergoing maintenance therapy of acute lymphoblastic leukemia

2019 ◽  
Vol 23 (2) ◽  
pp. 81-86
Author(s):  
Przemysław M. Krzaczek ◽  
Małgorzata Mitura-Lesiuk ◽  
Joanna Zawitkowska ◽  
Beata Petkowicz ◽  
Barbara Wilczyńska ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Maintenance Therapy ◽  
Lymphoblastic Leukemia ◽  
Oral Lesions ◽  
Serum Concentrations

scholarly journals Detectable Molecular Residual Disease at the Beginning of Maintenance Therapy Indicates Poor Outcome in Children With T-Cell Acute Lymphoblastic Leukemia

Blood ◽  
1997 ◽  
Vol 90 (3) ◽  
pp. 1226-1232 ◽  
Author(s):  
Salvatore P. Dibenedetto ◽  
Luca Lo Nigro ◽  
Sharon Pine Mayer ◽  
Giovanni Rovera ◽  
Gino Schilirò
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
T Cell ◽  
Maintenance Therapy ◽  
Residual Disease ◽  
Lymphoblastic Leukemia ◽  
Strong Predictor ◽  
Blot Hybridization ◽  
Cell Receptor ◽  
Dot Blot ◽  
Poor Outcome

Abstract The aims of this study were twofold: (1) to assess the marrow of patients with T-lineage acute lymphoblastic leukemia (T-ALL) for the presence of molecular residual disease (MRD) at different times after diagnosis and determine its value as a prognostic indicator; and (2) to compare the sensitivity, rapidity, and reliability of two methods for routine clinical detection of rearranged T-cell receptor (TCR). Marrow aspirates from 23 patients with T-ALL diagnosed consecutively from 1982 to 1994 at the Division of Pediatric Hematology and Oncology, University of Catania, Italy, were obtained at diagnosis, at the end of induction therapy (6 to 7 weeks after diagnosis), at consolidation and/or reinforced reinduction (12 to 15 weeks after diagnosis), at the beginning of maintenance therapy (34 to 40 weeks after diagnosis), and at the end of therapy (96 to 104 weeks after diagnosis). DNA from the patients' marrow was screened using the polymerase chain reaction (PCR) for the four most common TCR δ rearrangements in T-ALL (Vδ1Jδ1, Vδ2Jδ1, Vδ3Jδ1, and Dδ2Jδ1) and, when negative, further tested for the presence of other possible TCR δ and TCR γ rearrangements. After identification of junctional rearrangements involving V, D, and J segments by DNA sequencing, clone-specific oligonucleotide probes 5′ end-labeled either with fluorescein or with [γ-32P]ATP were used for heminested PCR or dot hybridization of PCR products of marrows from patients in clinical remission. For 17 patients with samples that were informative at the molecular level, the estimated relapse-free survival (RFS) at 5 years was 48.6% (±12%). The sensitivity and specificity for detection of MRD relating to the outcome were 100% and 88.9% for the heminested fluorescence PCR and 71.4% and 88.9% for Southern/dot blot hybridization, respectively. Predictive negative and positive values were 100% and 90.7% for heminested fluorescence PCR, respectively. The probability of RFS based on evidence of MRD as detected by heminested fluorescence PCR at the time of initiation of maintenance therapy was 100% and 0% for MRD-negative and MRD-positive patients, respectively. Thus, the presence of MRD at the beginning of maintenance therapy is a strong predictor of poor outcome, and the molecular detection of MRD at that time might represent the basis for a therapeutic decision about such patients. By contrast, the absence of MRD at any time after initiation of treatment strongly correlates with a favorable outcome. The heminested fluorescence PCR appears to be more accurate and more rapid than other previously used methods for the detection of residual leukemia.

scholarly journals Optimizing Therapy in the Modern Age: Differences in Length of Maintenance Therapy in Acute Lymphoblastic Leukemia

Blood ◽  
2020 ◽  
Author(s):  
David T Teachey ◽  
Stephen P. Hunger ◽  
Mignon L. Loh
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Maintenance Therapy ◽  
Randomized Clinical Trials ◽  
Lymphoblastic Leukemia ◽  
Maintenance Phase ◽  
High Rate ◽  
Intrathecal Therapy ◽  
Cooperative Groups ◽  
Significant Burden ◽  
Multi Agent

The majority of children and young adults with acute lymphoblastic leukemia (ALL) are cured with contemporary multi-agent chemotherapy regimens. The high rate of survival is largely the result of 70 years of randomized clinical trials performed by international cooperative groups. Contemporary ALL therapy usually consists of cycles of multi-agent chemotherapy given over 2-3 years that includes central nervous system (CNS) prophylaxis, primarily consisting of CNS-penetrating systemic agents and intrathecal therapy. While the treatment backbones vary between cooperative groups, the same agents are used and the outcomes are comparable. ALL therapy typically begins with 5-9 months of more intensive chemotherapy followed by a prolonged low intensity maintenance phase. Historically, a few cooperative groups treated boys with one more year of maintenance therapy than girls; whereas, the majority of groups treated boys and girls with equal therapy lengths. This practice arose because of inferior survival in boys with older less-intensive regimens. The extra year of therapy adds significant burden to patients and families and has short- and long-term risks that can be life-threatening and debilitating. The Children's Oncology Group (COG) recently changed its approach as part of their current generation of trials in B-ALL and is now treating boys and girls with the same duration of therapy. We provide the rationale behind this change, a review of the data and differences in practice across cooperative groups, and our perspective regarding the length of maintenance therapy.

Three versus five years of maintenance therapy are equivalent in childhood acute lymphoblastic leukemia: a report from the Childrens Cancer Study Group.

1989 ◽  
Vol 7 (3) ◽  
pp. 316-325 ◽  
Author(s):  
D R Miller ◽  
S L Leikin ◽  
V C Albo ◽  
H Sather ◽  
G D Hammond
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Complete Remission ◽  
Maintenance Therapy ◽  
Lymphoblastic Leukemia ◽  
Disease Free Survival ◽  
Study Group ◽  
Cancer Study ◽  
Cancer Study Group ◽  
Discontinue Therapy ◽  
The Difference

Childrens Cancer Study Group protocol 141 (CCG-141), a randomized trial, was designed in part to compare 3 v 5 years of maintenance therapy, to evaluate the role of late reinduction, and to identify factors that predict relapse after 3 years of continuous complete remission (CCR) in acute lymphoblastic leukemia (ALL). Of 880 patients entered on study, 827 (94%) achieved complete remission and 499 (56.7%) were in CCR after 3 years of maintenance therapy. Boys were required to have negative testicular biopsies before randomization. A total of 481 patients were eligible for the duration of therapy phase of the study. Of the 310 (64.4%) randomly assigned patients, 101 were entered on regimen A: discontinue therapy; 105 on regimen B: reinduction for 4 weeks, then discontinue therapy; and 104 on regimen C: continue maintenance therapy for 2 more years, then discontinue. After a median follow-up of over 72 months, no significant differences in disease-free survival (DFS) or survival were noted in the three regimens. At 6 years from randomization, 93.0%, 89.1%, and 89.1% of patients on regimens A, B, and C, respectively, remained in CCR. Isolated CNS or overt testicular relapses were not significantly different in any of the study regimens. Isolated testicular relapse after a negative biopsy occurred in only two of 137 randomized males (1.5%). DFS (P = .10) and survival (P = .83) were not significantly different for all boys and girls randomized to regimens A, B, or C. The relapse rate was higher in boys than in girls randomized to discontinue therapy (11% v 4%), but the difference was not statistically significant (P = .14). Except for the presence of occult testicular leukemia (TL) in males, no other factors were identified that predicted for adverse events after 3 years of CCR. We conclude that prolongation of maintenance therapy beyond 3 years does not improve survival or decrease the risk of relapse.

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