Cotrimoxazole prophylaxis of Pneumocystis carinii infection during the treatment of childhood acute lymphoblastic leukemia – beware non compliance in older children and adolescents

2001 ◽  
Vol 9 (7) ◽  
pp. 552-553 ◽  
Author(s):  
Elio Castagnola ◽  
Daniela Zarri ◽  
Daniela Caprino ◽  
Giuseppe Losurdo ◽  
Concetta Micalizzi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Children And Adolescents ◽  
Lymphoblastic Leukemia ◽  
Pneumocystis Carinii ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Older Children ◽  
Cotrimoxazole Prophylaxis ◽  
Pneumocystis Carinii Infection

scholarly journals Postinduction Dexamethasone and Individualized Dosing of Escherichia Coli L-Asparaginase Each Improve Outcome of Children and Adolescents With Newly Diagnosed Acute Lymphoblastic Leukemia: Results From a Randomized Study—Dana-Farber Cancer Institute ALL Consortium Protocol 00-01

2013 ◽  
Vol 31 (9) ◽  
pp. 1202-1210 ◽  
Author(s):  
Lynda M. Vrooman ◽  
Kristen E. Stevenson ◽  
Jeffrey G. Supko ◽  
Jane O'Brien ◽  
Suzanne E. Dahlberg ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Acute Lymphoblastic Leukemia ◽  
Children And Adolescents ◽  
Lymphoblastic Leukemia ◽  
Fixed Dose ◽  
Newly Diagnosed ◽  
Older Children ◽  
Improve Outcome ◽  
Dana Farber Cancer Institute ◽  
Dosing Method

Purpose We assessed the toxicity and efficacy of dexamethasone and a novel dosing method of Escherichia coli L-asparaginase (EC-Asnase) in children and adolescents with newly diagnosed acute lymphoblastic leukemia (ALL). Patients and Methods Patients achieving complete remission (CR) on Dana-Farber Cancer Institute ALL Consortium Protocol 00-01 were eligible for random assignment to 1) dexamethasone or prednisone, administered as 5-day pulses, every 3 weeks, and 2) weekly EC-Asnase, administered as a 25,000 IU/m2 fixed dose (FD) or individualized dose (ID) starting at 12,500-IU/m2, adjusted every 3 weeks based on nadir serum asparaginase activity (NSAA) determinations. Results Between 2000 and 2004, 492 evaluable patients (ages 1 to 18 years) enrolled; 473 patients (96%) achieved CR. Four hundred eight patients (86%) participated in the corticosteroid randomization and 384 patients (81%) in the EC-Asnase randomization. With 4.9 years of median follow-up, dexamethasone was associated with superior 5-year event-free survival (EFS; 90% v 81% for prednisone; P = .01) but higher rates of infection (P = .03) and, in older children, higher cumulative incidence of osteonecrosis (P = .02) and fracture (P = .06). ID EC-Asnase had superior 5-year EFS (90% v 82% for FD; P = .04), but did not reduce the frequency of asparaginase-related toxicity. Multivariable analysis identified both dexamethasone and ID EC-Asnase as independent predictors of favorable EFS. Conclusion There was no overall difference in skeletal toxicity by corticosteroid type; dexamethasone was associated with more infections and, in older children, increased incidence of osteonecrosis and fracture. There was no difference in asparaginase-related toxicity by EC-Asnase dosing method. Dexamethasone and ID EC-Asnase were each associated with superior EFS. Monitoring NSAA during treatment with EC-Asnase may be an effective strategy to improve outcome in pediatric ALL.

Genetic characterization of high hyperdiploidy in childhood acute lymphoblastic leukemia

2009 ◽  
Vol 221 (03) ◽  
Author(s):  
R Vagkopoulou ◽  
C Eckert ◽  
U Ungethüm ◽  
G Körner ◽  
M Stanulla ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Genetic Characterization ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia
Sign in / Sign up

Export Citation Format

Share Document