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International Journal of Hematology

, Volume 73, Issue 3, pp 369–377 | Cite as

Long-Term Outcome of Treatment With Protocols AL841, AL851, and ALHR88 in Children With Acute Lymphoblastic Leukemia: Results Obtained by the Kyushu-Yamaguchi Children’s Cancer Study Group

  • Akinobu Matsuzaki
  • Eiichi Ishii
  • Yoshihisa Nagatoshi
  • Haruhiko Eguchi
  • Hiroyuki Koga
  • Fumio Yanai
  • Hiroko Inada
  • Keiko Nibu
  • Yuji Tamai
  • Kensuke Akiyoshi
  • Hideki Nakayama
  • Toshiro Hara
  • Hiromichi Take
  • Sumio Miyazaki
  • Jun Okamura
Case Report

Abstract

We analyzed the long-term outcome and late effects of treatment in 187 patients with childhood acute lymphoblastic leukemia (ALL) diagnosed between 1984 and 1990. Overall survival and event-free survival rates were 68.2% +- 3.7% and 63.2% +- 3.6% at 15 years, respectively. Of 55 patients who relapsed after achieving the first complete remission (CR), only 17.4% were rescued by salvage therapy. The advantage of stem cell transplantation over chemotherapy was observed only in those patients with bone marrow relapse during therapy. The SD for score height in patients maintaining the first CR significantly decreased at the time of final follow-up compared with that at diagnosis: 0.059 to -0.800 (P < .0001). The decrease was remarkable in patients younger than 5 years at diagnosis. Other late effects included mild liver dysfunction in 18% and hepatitis C virus infection in 9%. Congestive heart failure was observed in only 2.9% of patients despite the high cumulative dose of daunorubicin (450 mg/m2). Although the survival rates of patients on our protocols were comparable to those of other study groups, some modification, including reduction in dose of cranial irradiation and/or anticancer drugs, should be considered to reduce late adverse effects in survivors of childhood ALL.

Key words

Acute lymphoblastic leukemia Child Chemotherapy Growth impairment Late effect 

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Copyright information

© The Japanese Society of Hematology 2001

Authors and Affiliations

  • Akinobu Matsuzaki
    • 1
    • 2
  • Eiichi Ishii
    • 3
  • Yoshihisa Nagatoshi
    • 4
  • Haruhiko Eguchi
    • 5
  • Hiroyuki Koga
    • 6
  • Fumio Yanai
    • 7
  • Hiroko Inada
    • 5
  • Keiko Nibu
    • 7
  • Yuji Tamai
    • 8
  • Kensuke Akiyoshi
    • 9
  • Hideki Nakayama
    • 10
  • Toshiro Hara
    • 2
  • Hiromichi Take
    • 11
  • Sumio Miyazaki
    • 6
  • Jun Okamura
    • 4
  1. 1.Division of Child HealthSchool of Health Sciences, Kyushu UniversityFukuokaJapan
  2. 2.Department of PediatricsGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
  3. 3.Division of PediatricsHamanomachi HospitalFukuokaJapan
  4. 4.Section of PediatricsNational Kyushu Cancer CenterFukuokaJapan
  5. 5.Department of PediatricsKurume UniversityKurumeJapan
  6. 6.Department of PediatricsSaga Medical SchoolSagaJapan
  7. 7.Department of PediatricsFukuoka UniversityFukuokaJapan
  8. 8.Division of PediatricsOita Prefectural HospitalOitaJapan
  9. 9.Department of PediatricsOita Medical UniversityOitaJapan
  10. 10.Division of PediatricsNational Beppu HospitalBeppuJapan
  11. 11.Department of PediatricsKagoshima City HospitalKagoshimaJapan

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