title: Triple intrathecal therapy without cranial irradiation for central nervous system preventive therapy in childhood acute lymphoblastic leukemia.
abstract: BACKGROUND
  To evaluate the treatment results of central nervous system preventive therapy (CNSP) with triple intrathecal therapy (TIT) alone in children with acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  We retrospectively studied a cohort of 59 patients with median follow-up time 50.6 months (range: 27-80 months) at a single institution in Taiwan. Patients with ALL were classified in risk groups at diagnosis. TPOG-ALL-93 protocols and TPOG-ALL-2002 protocols were used. Both protocols were for multicenter studies in Taiwan and contained protocols for standard-risk (SR), high-risk (HR), and very-high-risk (VHR) patients. In this study, we used TIT alone for CNSP. In all ALL patients, methotrexate, hydrocortisone, and cytarabine were given at age-dependent doses.
  
  
  RESULTS
  As of October 2006, patients had a 3-year event-free survival and an overall survival 89.4 +/- 4.1% (S.E.) and 93.1 +/- 3.3%, respectively. Under TIT no patients had complications such as seizure, encephalitis, or infection, and no morbidities like those caused by cranial irradiation. In this study, we used TIT alone for CNSP and had no CNS relapse.
  
  
  CONCLUSIONS
  In the context of effective systemic therapy, TIT alone appears to be effective CNSP for most patients with ALL.
authors: Division of Pediatric Hematology and Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
authors: Wei-Ying
authors: WY
authors: Lin
authors: Hsi-Che
authors: HC
authors: Liu
authors: Ting-Chi
authors: TC
authors: Yeh
authors: Lin-Yen
authors: LY
authors: Wang
authors: Der-Cherng
authors: DC
authors: Liang
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001215:Asparaginase / Q000494:pharmacology; D002490:Central Nervous System / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects; D003520:Cyclophosphamide / Q000494:pharmacology; D003561:Cytarabine / Q000008:administration & dosage / Q000494:pharmacology; D003907:Dexamethasone / Q000008:administration & dosage; D018572:Disease-Free Survival; D015251:Epirubicin / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D007223:Infant; D007278:Injections, Spinal; D017254:Leukemic Infiltration / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000473:pathology / Q000532:radiotherapy*; D011239:Prednisolone / Q000008:administration & dosage; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003561:Cytarabine; D015251:Epirubicin; D014750:Vincristine; D003907:Dexamethasone; D003520:Cyclophosphamide; D011239:Prednisolone; D015122:Mercaptopurine; D001215:Asparaginase; D006854:Hydrocortisone; D008727:Methotrexate