Testicular infiltrates in children with acute lymphoblastic leukemia: a prospective study.
Testicular infiltrates in children with acute lymphoblastic leukemia: a prospective study.
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急性淋巴细胞白血病儿童睾丸浸润：一项前瞻性研究。
DOI：
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发表时间：
1984
期刊：
影响因子：
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通讯作者：
N. Torán
中科院分区：
文献类型：
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作者：
J. Ortega;G. Javier;N. Torán
本文对68例首次缓解期（1974 ~ 1981年）急性淋巴细胞白血病患儿的睾丸浸润的发生率进行了前瞻性研究。所有男孩都在14岁以下，他们接受了D.74和Petema 7/78方案的治疗。7例患者（10.3%）在化疗期间出现孤立性睾丸复发（ITR）。43例睾丸活检中有13例（31%）发现白血病浸润，另外两例发现存在争议。三个男孩，其中两个先前活检阴性，在治疗停止后6至18个月有ITR。最后，另外三名患者的睾丸和骨髓同时复发，一名在化疗期间，两名在抑制后。首次缓解的23例患者（33.8%）有明显或隐匿性ITR。睾丸白血病的总体估计发病率在所有组中为40%。在初始WBC计数超过20 × 10（9）/1的男孩中，早期和隐匿性ITR的发生率较高。ITR的治疗通常包括局部放疗（20-25戈伊），新的诱导治疗，然后是2年的维持治疗;在3例早期ITR患者中，还进行了扁桃体切除术，6例患者接受了新的CNS预防性治疗。7例早期ITR患者的临床病程对5例患者不利，随后发生血液学复发和死亡; 1例患者长期无病生存（80 +个月），另1例为近期病例。13例隐匿性浸润患者中有10例持续缓解，4例停止治疗，随访时间超过66个月。3例晚期ITR患者在新的治疗停止后8-18个月时第二次缓解。从这项研究中可以得出结论，ITR的预后与表现阶段有关：早期ITR的情况下是不利的，但在隐匿性浸润，通过常规活检检测，并在晚期ITR联合治疗在大多数情况下是有效的。
The incidence of testicular infiltrates in 68 boys with acute lymphoblastic leukemia in first remission (1974-81), was prospectively investigated through careful clinical examination and routine bilateral biopsies at 2-3 years of remission. All boys were under 14 years of age and they were treated with protocols D.74 and Pethema 7/78. Seven patients (10.3%) presented an isolated testicular relapse (ITR) during the chemotherapy period. In 13 of the 43 testicular biopsies (31%) leukemic infiltrates were found, and in another two findings were controversial. Three boys, two with previous negative biopsies, had an ITR 6 to 18 months after therapy was stopped. Finally, three others had simultaneous relapses in testes and bone marrow, one during chemotherapy and two after suppression. In all, 23 patients (33.8%) in first remission had overt or occult ITR. Overall estimated incidence rate of testes leukemia is 40% in all the groups. Incidence of early and occult ITR was higher in boys with initial WBC counts over 20 X 10(9)/1. Therapy in ITR generally consisted of local radiotherapy (20-25 Gy), a new induction treatment followed by 2-year maintenance treatment; in three patients with early ITR, orchidectomy was also performed and six were given a new CNS preventive treatment. Clinical course in the seven patients with early ITR was unfavourable in five, with subsequent hematological relapses and death; one had a long-term disease-free survival (80 + months) and the other was a recent case. Ten of the 13 patients with occult infiltrates continued in remission and four were off treatment with a follow-up of over 66 months. The three patients with late ITR were in 2nd remission at 8-18 months after a new cessation of therapy. It may be concluded from this study that prognosis in ITR is related to the phase of presentation: it is unfavourable in cases of early ITR, but in occult infiltrates, detected by routine biopsy, and in late ITR combined therapy is effective in most cases.
儿童急性淋巴细胞白血病的强化治疗和预后因素：CCG 141。儿童癌症研究组的报告。
DOI：
10.1007/978-3-642-67984-1_12
发表时间：
1981
期刊：
Haematology and blood transfusion
影响因子：
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作者：
Miller,DR;Leikin,S;Albo,V;Sather,H;Karon,M;Hammond,D
通讯作者：
Hammond,D