Consequences of intensive therapy of acute lymphoblastic leukemia in children in initial complete remission lasting more than five years.
Complex clinical, neurological and psychological examination was carried out in 23 children with acute lymphoblastic leukemia (ALL), being in complete initial remission from 5 to 12 years and without medication following the successful intensive therapy according to the protocol 0171 from 2 1/2 to 9 years. Somatic deficiency was observed in 2 children. Slightly hypoplastic bone marrow haemopoesis was found in 2 children. All children had normal haemogram. In 7 children lowered values of E-rosettes and in 3 children lowered levels of serum IgA were detected. Two children were HBsAg positive, in one of them with mild fibrosis was found at biopsy. Pathological neurological findings occurred in 7 children; pathological electromyogram (EMG) and electroencephalogram (EEG) in 8 and 5 children, respectively. Deviations of intellectual development were observed in 13 children. Deviations found can be connected in particular with long-term antileukemic therapy, especially with neurotoxic effects of some components of therapeutic regimen used (methotrexate, brain irradiation).
D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001500:BCG Vaccine / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D003561:Cytarabine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D015122:Mercaptopurine / Q000009:adverse effects; D008727:Methotrexate / Q000009:adverse effects; D009422:Nervous System Diseases / Q000209:etiology; D011241:Prednisone / Q000009:adverse effects; D013997:Time Factors; D014750:Vincristine / Q000009:adverse effects
D001500:BCG Vaccine; D003561:Cytarabine; D014750:Vincristine; D015122:Mercaptopurine; D011241:Prednisone; D008727:Methotrexate