[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.
Kaspers
G J
GJ
Afd. Kindergeneeskunde, Academisch Ziekenhuis, Vrije Universiteit, Amsterdam.
Pieters
R
R
Klumper
E
E
de Waal
F C
FC
Veerman
A J
AJ
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.