[The treatment of recurrence in children with acute lymphatic leukemia. Current results and various developments].
The results of current treatment of relapsed childhood acute lymphoblastic leukemia (ALL) are discussed, together with some recent developments which (might) influence such treatment. At present more than 95% of children with ALL will achieve a complete remission (CR), and +/- 70% will remain in CR. Nevertheless, 20-30% of the patients suffer a relapse, which implies a less favorable prognosis. However, after intensive treatment a part of these patients will have a prolonged second complete remission: 30-50% of children with a late relapse and 0-20% of children with an early relapse. It is important to prevent the occurrence of a relapse. The identification at diagnosis of patients at high risk for a relapse, and a subsequent more specific and more intensive treatment of these patients might contribute to that goal. Well-known risk factors are briefly mentioned, factors of which the prognostic significances is therapy-dependent. In addition, the treatment of relapsed ALL needs further improvement. Some alternatives to achieve this goal are discussed, including the role of in vitro cytostatic drug resistance testing.
Afd. Kindergeneeskunde, Academisch Ziekenhuis, Vrije Universiteit, Amsterdam.
G J
GJ
Kaspers
R
R
Pieters
E
E
Klumper
F C
FC
de Waal
A J
AJ
Veerman
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006133:Growth Substances / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D014410:Tumor Stem Cell Assay
D006133:Growth Substances
De behandeling van een recidief bij kinderen met acute lymfatische leukemie. Huidige resultaten en enkele ontwikkelingen.