[A case of acute lymphoblastic leukemia and chronic renal failure resulting in complete remission with chronic hemodialysis].
We report here a case of acute lymphoblastic leukemia (ALL) which occurred in a 34-year-old female with chronic renal failure (CRF). Although she was placed on chronic hemodialysis therapy (HD), she achieved complete remission (CR) with the use of chemotherapy. Our therapeutic regime was as follows. 1. The full dose of the Japan adult leukemia study group (JALSG)-ALL90 protocol was given and consisted of vincristine, cyclophosphamide, doxorubicin, mitoxantrone and predonisolone at the stage of CRF (serum creatinine concentration equal to/or less than 5.6 mg/dl). 2. The full dose of etoposide and 80% dose of cyclophosphamide, aclarubicin and vindesine used for consolidation therapy may be toxic when they are given after HD. 3. The dose of Enocitabine should be divided in every 12h in the context of toxicity to bone marrow and the mechanism of action. In conclusion, to induce remission in the case of acute lymphoblastic leukemia, we suggest that it is possible to give 80% to a full dose of JALSG-ALL90 protocol, despite the complication of CRF or HD.
Sasaki
T
T
Department of Internal Medicine, Fukui Red Cross Hospital, Japan.
Hayashi
M
M
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D010677:Philadelphia Chromosome; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D012074:Remission Induction; D006435:Renal Dialysis