Results of Remission Induction of 4'-O-Tetrahydropyranyladriamycin(THP) in the Children's Cancer and Leukemia Study Group 911 Study and 941 HR Pilot Study for Acute Lymphoblastic Leukemia.

  • KAWAKAMI Tetsuo
    Department of Pediatrics, Faculty of Medicine, Tottori University, Children's Cancer and Leukemia Study Group (CCLSG)
  • NISHIKAWA Ken-ichi
    Department of Pediatrics, Faculty of Medicine, Tottori University, Children's Cancer and Leukemia Study Group (CCLSG)
  • KOIZUMI Shouichi
    Departmentof Pediatrics, Kanazawa University School of Medicine, Children's Cancer and Leukemia Study Group (CCLSG)
  • WATANABE Arata
    Department of Pediatrics, Akita University School of Medicine, Children's Cancer and Leukemia Study Group (CCLSG)
  • KIKUTA Atsushi
    Department of Pediatrics, Fukushima Medical School, Children's Cancer and Leukemia Study Group (CCLSG)
  • MIMAYA Jun-ichi
    Division of Hematology and Oncology, Shizuoka Children's Hospital, Children's Cancer and Leukemia Study Group (CCLSG)
  • SEKINE Isao
    Department of Pediatrics, National Defence Medical College, Children's Cancer and Leukemia Study Group (CCLSG)
  • MIYAKE Munenori
    Department of Pediatrics, Osaka Medical College, Children's Cancer and Leukemia Study Group (CCLSG)
  • IWAI Asayuki
    National Kagawa Children's Hospital, Children's Cancer and Leukemia Study Group (CCLSG)
  • KAWAKAMI Kiyoshi
    Department of PediatricS, KagoShima University school of Medicine, Children's Cancer and Leukemia Study Group (CCLSG)
  • GUSHIKEN Toshiki
    Department of Pediatrics, Unirersity of Ryuhyus, Children's Cancer and Leukemia Study Group (CCLSG)
  • KATANO Naoyuki
    Department of Pediatrics, Aichi Medical Unirersity, Children's Cancer and Leukemia Study Group (CCLSG)
  • TSURUSAWA Masahito
    Department of Pediatrics, Aichi Medical Unirersity, Children's Cancer and Leukemia Study Group (CCLSG)
  • FUJIMOTO Takeo
    Department of Pediatrics, Aichi Medical Unirersity, Children's Cancer and Leukemia Study Group (CCLSG)

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  • 4′‐O‐tetrahydropyranyladriamycin(THP)を併用した急性リンパ性白血病に対する小児がん白血病研究グループ(CCLSG)911 studyと941 HR pilot studyの寛解導入の成績

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To evaluate the safety of 4'-O-tetrahydropyranyladriamycin (THP), we examined the results of the so-called “911 study and 941 high-risk (HR) pilot study” of acute lymphoblastic leukemia (ALL) of the Children's Cancer and Leukemia Study Group. In the low-risk (LR) patients of the 911 study, THP was used. In the intermediate-risk (IR) patients of the 911 study and the HR patients of the 941 pilot study, THP and triple intrathecal injections (triple i. t., methotrexate 12.5 mg, cytarabine 30 mg, hydrocortisone 50 mg) were used. In the 911HR patients, triple i.t. was used. The rates of remission of the 911IR and 941HR pilot patients who used THP and triple i.t. were 88.2% and 91.9%, respectively. The rates of failure and chemotherapy interruption were 50.0% and 42.9%, respectively. The mean durations of granulocytepenia (<500/μl) were 20.4± 9.7 days and 24.8 ± 8.2 days, respectively. The rates of infection were 91.9% and 78.6%, respectively. The mean durations of thrombocytepenia (<50 × 103/μl) were 10.2 ± 8.0 days and 18.5 ± 10.4 days, respectively. All patients in the 911IR group who failed died because of infection. The mean duration length of thrombocytepenia in the 941HR pilot patients was significantly longer than the 911 HR patients. It should be recognized that THP and triple i. t.may cause severe bone marrow suppression in remission induction for ALL.

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