Journal of Clinical Oncology, Vol 5, 1960-1967, Copyright © 1987 by American Society of Clinical Oncology
The value of intensive combination chemotherapy for juvenile chronic myelogenous leukemia
HS Chan, Z Estrov, SS Weitzman and MH Freedman
Division of Hematology-Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
Nine children with juvenile chronic myelogenous leukemia (JCML) were
diagnosed in an 8-year period from 1977 to 1984. The clinical courses and
outcomes of five patients who received minimal or no chemotherapy were
compared with that of four patients who were treated with intensive acute
nonlymphoblastic leukemia (ANLL) combination chemotherapy. None of the five
patients in the former group achieved clinical remission and their
survivals were 1, 4, 4, 7, and 29 months, respectively. All four patients
in the latter group achieved clinical remissions that lasted 11, 21, 21,
and 27 + months, respectively. The durations of their survival (21, 26, 30,
and 32 + months) were significantly better than the five patients who
received minimal or no chemotherapy (P less than .05). Despite
hospitalizations for chemotherapy and for treatment of
chemotherapy-associated complications, the clinical status and quality of
life of the children who achieved clinical remission were superior to those
who remained in relapse. Although intensive chemotherapy induced lengthy
remissions, three of the four patients have relapsed. Cytogenetic and cell
culture data indicated that the monocytic-macrophage cells characteristic
of JCML appeared to be suppressed during remission rather than totally
eliminated. We recommend that ANLL-type combination chemotherapy be used as
the initial treatment of JCML because of its promptness in effecting
clinical remissions. Improved maintenance and consolidation protocols have
to be developed to produce durable remissions and cures. Alternatively,
bone marrow transplantation may be a useful option soon after remission is
achieved with chemotherapy.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
F. Locatelli, P. Nollke, M. Zecca, E. Korthof, E. Lanino, C. Peters, A. Pession, H. Kabisch, C. Uderzo, C. S. Bonfim, et al.
Hematopoietic stem cell transplantation (HSCT) in children with juvenile myelomonocytic leukemia (JMML): results of the EWOG-MDS/EBMT trial
Blood,
January 1, 2005;
105(1):
410 - 419.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Worth, K. Rao, D. Webb, J. Chessells, J. Passmore, and P. Veys
Successful treatment of juvenile myelomonocytic leukemia relapsing after stem cell transplantation using donor lymphocyte infusion
Blood,
March 1, 2003;
101(5):
1713 - 1714.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. G. Woods, D. R. Barnard, T. A. Alonzo, J. D. Buckley, N. Kobrinsky, D. C. Arthur, J. Sanders, S. Neudorf, S. Gold, and B. J. Lange
Prospective Study of 90 Children Requiring Treatment for Juvenile Myelomonocytic Leukemia or Myelodysplastic Syndrome: A Report From the Children's Cancer Group
J. Clin. Oncol.,
January 15, 2002;
20(2):
434 - 440.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. D. Emanuel, R. C. Snyder, T. Wiley, B. Gopurala, and R. P. Castleberry
Inhibition of juvenile myelomonocytic leukemia cell growth in vitro by farnesyltransferase inhibitors
Blood,
January 15, 2000;
95(2):
639 - 645.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. O. Iversen and M. Sioud
Modulation of Granulocyte-Macrophage Colony-Stimulating Factor Gene Expression by a Tumor Necrosis Factor alpha Specific Ribozyme in Juvenile Myelomonocytic Leukemic Cells
Blood,
December 1, 1998;
92(11):
4263 - 4268.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. O. Iversen, I. D. Lewis, S. Turczynowicz, H. Hasle, C. Niemeyer, K. Schmiegelow, S. Bastiras, A. Biondi, T. P. Hughes, and A. F. Lopez
Inhibition of Granulocyte-Macrophage Colony-Stimulating Factor Prevents Dissemination and Induces Remission of Juvenile Myelomonocytic Leukemia in Engrafted Immunodeficient Mice
Blood,
December 15, 1997;
90(12):
4910 - 4917.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Arico, A. Biondi, and C.-H. Pui
Juvenile Myelomonocytic Leukemia
Blood,
July 15, 1997;
90(2):
479 - 488.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Zvulunov, Y. Barak, and A. Metzker
Juvenile Xanthogranuloma, Neurofibromatosis, and Juvenile Chronic Myelogenous Leukemia: World Statistical Analysis
Arch Dermatol,
August 1, 1995;
131(8):
904 - 908.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C.-H. Pui, M. Arico, J. Donadieu, R. P. Castleberry, and P. D. Emanuel
Isotretinoin for Juvenile Chronic Myelogenous Leukemia
N. Engl. J. Med.,
June 1, 1995;
332(22):
1520 - 1521.
[Full Text]
|
|
|
|
|
|
|
R. P. Castleberry, P. D. Emanuel, K. S. Zuckerman, S. Cohn, L. Strauss, R. L. Byrd, A. Homans, S. Chaffee, R. Nitschke, and R. J. Gualtieri
A Pilot Study of Isotretinoin in the Treatment of Juvenile Chronic Myelogenous Leukemia
N. Engl. J. Med.,
December 22, 1994;
331(25):
1680 - 1684.
[Abstract]
[Full Text]
|
|
|
|
