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4 小児・思春期白血病に対する本邦共通プロトコールの策定(血液疾患の治療をめぐる進歩,第658回新潟医学会)

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  • Development of Nation-wide Chemotherapy Protocols for Childhood and Adolescent Leukemia in Japan (Progress in the Treatment of Hematologic Diseases)

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Advances in chemotherapy and supportive treatment have improved the mortality and morbidity of leukemia in childhood. In Japan, multicenter-cooperative clinical studies for childhood leukemia had begun since 1981. Currently, there are 4 major multicenter study groups (CCLSG, TCCSG, KYCCSG, JACLS), As a member of CCLSG, we have been treating children with acute lymphoblastic leukemia (ALL) according to the successive CCLSG protocols. Around 80% of event free survival rate has been achieved by the use of modern chemotherapy protocols in the Western countries, as well as in Japan. In 2003, the 4 groups merged to form an inter-group nation-wide study group ‘Japan Pediatric Leukemia and Lymphoma Study Group (JPLSG)’. The primary aim of JPLSG is to develop more efficacious treatment for relatively rare diseases (such as infant ALL, lymphoma, and BCR-ABL-positive ALL) and to standardize treatment for childhood hematological malignancies in Japan. In the very near future, nation-wide protocols for childhood and adolescent ALL will be begun. In those protocols, I hope that more chances of cure and fewer occurrences of long-term sequelae will be realized in children and adolescents by sophisticating treatment and omission of preventive radiotherapy to central nerves systems.

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