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Central Nervous System Leukemia

Prevention and Treatment

  • Renato Mastrangelo
  • David G. Poplack
  • Riccardo Riccardi
Book

Part of the Developments in Oncology book series (DION, volume 13)

Table of contents

  1. Front Matter
    Pages I-X
  2. A. M. Mauer, J. Ochs, W. P. Bowman, L. Ch’ien, W. Evans, R. Ragland et al.
    Pages 17-25
  3. W. A. Bleyer, C. Level, H. N. Sather, D. J. Niebrugge, P. F. Coccia, S. Siegel et al.
    Pages 27-37
  4. Y. Ravindranath, K. Bhambhani, John K. Kelly, G. Schultz, I. Warrier, B. Considine et al.
    Pages 39-48
  5. P. J. Moe, M. Seip, P. H. Finne, S. Kolmannskog
    Pages 63-69
  6. M. L. N. Willoughby
    Pages 113-122
  7. Back Matter
    Pages 137-139

About this book

Introduction

In the past 10 to IS years there has been dramatic improvement in the survival of children with acute lymphoblastic leukemia. At the present time, over 50% of children with this disease will be alive and free of their disease at least 5 years from the time of their initial diagnosis. Although a number of factors have contributed to this improvement, perhaps none has been as important as the institution of central nervous system preventive therapy (eNS prophylaxis). However, despite the efficacy of eNS prophylaxis, the prevention and treatment of central nervous system leukemia continues to pose a formidable clinical challenge to the pediatric oncologist. Although successful in most cases, eNS preventive therapy remains ineffective for a small but significant subset of patients at high risk for developing eNS disease. Moreover, it has become increasingly evident that some methods of eNS preventive therapy are associated with long-term, adverse eNS sequelae. Thus, considerable controversy exists regarding the optimal method of eNS prophylaxis. Treatment of the patient who develops overt meningeal leukemia has not been as successful and continues to pose a major clinical challenge. Despite the ability of intrathecal chemotherapy and/or radiation therapy to induce eNS remission, most patients suffer subsequent relapse and ultimate survival is usually signifi­ cantly compromised. It is evident that newer approaches to treatment for this patient group must be identified before major improvement for this patient group is likely to occur.

Keywords

chemotherapy leukemia pathology prevention radiation therapy

Editors and affiliations

  • Renato Mastrangelo
    • 1
  • David G. Poplack
    • 2
  • Riccardo Riccardi
    • 1
  1. 1.Clinica PediatricaUniversità CattolicaRomaItaly
  2. 2.Pediatric Oncology BranchNational Cancer InstituteBethesdaUSA

Bibliographic information

  • DOI https://doi.org/10.1007/978-94-009-6708-3
  • Copyright Information Springer Science+Business Media B.V. 1983
  • Publisher Name Springer, Dordrecht
  • eBook Packages Springer Book Archive
  • Print ISBN 978-94-009-6710-6
  • Online ISBN 978-94-009-6708-3
  • Buy this book on publisher's site