Comparison of two methods of preventing central nervous system leukemia.
Comparison of two methods of preventing central nervous system leukemia.
复制标题
两种预防中枢神经系统白血病方法的比较。
作者：
R. Aur;H. Hustu;M. Verzosa;A. Wood;J. Simone
本项ALL儿童对照研究旨在以前瞻性方式确定两种形式的“预防性”CNS治疗预防CNS复发和多药化疗期间定期长春新碱-泼尼松“脉冲”的相对疗效和毒性。经颅照射（2400拉德）加鞘内注射甲氨蝶呤，45例患者中有3例发生中枢神经系统白血病。颅脊髓照射（2400拉德）后，49例中有2例发生CNS白血病。颅脊髓照射与更多的白细胞减少和化疗中断有关。“脉搏”与缓解持续时间的改善无关。我们目前选择的中枢神经系统治疗是颅照射加鞘内甲氨蝶呤，因为它需要更少的时间，并可能避免证明短期副作用和脊髓照射可能的长期影响。
This controlled study of children with ALL was designed to determine in a prospective manner the relative efficacy and toxicity of two forms of "prophylactic" CNS therapy for preventing CNS relapse and of periodic vincristine-prednisone "pulses" during multiple agent chemotherapy. Following cranial irradiation (2400 rads) plus intrathecal methotrexate, 3 of 45 patients developed CNS leukemia. Following craniospinal irradiation (2400 rads), 2 of 49 developed CNS leukemia. Craniospinal irradiation was associated with more leukopenia and interruptions of chemotherapy. "Pulses" were not associated with improvement of remission duration. Our current choice of CNS therapy is cranial irradiation plus intrathecal methotrexate because it takes less time and may avoid demonstrated short-term side effects and possible long-term effects of spinal irradiation.