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Prognosis after acute lymphoblastic leudaemia



Prognosis after acute lymphoblastic leudaemia



Developmental Medicine and Child Neurology 17(2): 244-247



The long-term sequelae of current treatment methods are still relatively unknown. The only acute effect of prophylactic CNS radiotherapy is the 6 wk somnolence syndrome, which was recognized in .apprx. 60-70% of children receiving prophylactic CNS radiotherapy. Bone exposure results in growth impairment which may be apparent within 6 mo. of treatment. The carcinogenic risks of radiation are almost impossible to predict. Immunosuppressive effects are immediate and long-term, with persistent lymphopenia involving T (thymus-derived) lymphocytes. The side effects of chemotherapy are more unknown than those of radiotherapy. Toxic effects of methotrexate and 6-mercaptopurine include hepatic and pulmonary fibrosis, residual paralysis and cerebral impairment. Cyclophosphamide may induce gonadal impairment. Oncogenic effects were recently reported. Although the present treatment methods may cause some serious sequelae, it must be remembered that only 10 yr ago < 1% of these children were alive 5 yr after diagnosis and the median survival was only 17 mo. Today there is hope that half of them may survive disease free to live a normal life-span. Until less toxic treatment methods become available, efforts should be directed to the limitation and amelioration of adverse effects, while striving to ensure that as many patients as possible survive. This can best be achieved by treating all children in regional clinics, in cooperation with the local pediatrician and family doctor.

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Accession: 068540459

Download citation: RISBibTeXText

PMID: 1055705

DOI: 10.1111/j.1469-8749.1975.tb03478.x


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